AN ACT
RELATING TO INSURANCE; ENACTING A NEW SECTION OF THE PATIENT
PROTECTION ACT TO PROVIDE FOR THE APPOINTMENT AND COMPENSATION OF QUALIFIED
INDIVIDUALS TO REVIEW EXTERNAL GRIEVANCE APPEALS.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
Section 1. Section 59A-57-1 NMSA 1978 (being Laws 1998,
Chapter 107, Section 1) is amended to read:
"59A-57-1. SHORT TITLE.‑‑Chapter 59A,
Article 57 NMSA 1978 may be cited as the "Patient Protection
Act"."
Section 2. A new section of the Patient Protection Act
is enacted to read:
"EXTERNAL GRIEVANCE
APPEALS--APPOINTMENT--
COMPENSATION.--
A. The superintendent may appoint one or more
qualified individuals to review external grievance appeals.
B. The superintendent shall fix the reasonable
compensation of each appointee based upon, but not limited to, compensation
amounts suggested by national or state legal or medical professional societies,
organizations or associations.
C. Upon completion of the external grievance
appeal review, the superintendent shall prepare a detailed statement of
compensation due each appointee and shall present the statement to the
enrollee's health insurer.
D. The enrollee's health insurer shall pay the
compensation directly to each appointee who participated in the external
grievance appeal review.
E. The superintendent shall promulgate rules to
implement this section."