NOTE: As provided in LFC policy, this report is intended only for use by the standing finance committees of the legislature.  The Legislative Finance Committee does not assume responsibility for the accuracy of the information in this report when used for other purposes.

The most recent FIR version (in HTML & Adobe PDF formats) is available on the Legislative Website. The Adobe PDF version includes all attachments, whereas the HTML version does not. Previously issued FIRs and attachments may be obtained from the LFC in Suite 101 of the State Capitol Building North.

F I S C A L I M P A C T R E P O R T

SPONSOR:	Miera		DATE TYPED:	2/6/03		HB	265
SHORT TITLE:		Recognition of Doctors of Oriental Medicine				SB
					ANALYST:		Wilson

APPROPRIATION

Appropriation Contained		Estimated Additional Impact		Recurring or Non-Rec	Fund Affected
FY03	FY04	FY03	FY04
			See Narrative

Duplicates SB 371

Relates to HB 266 & SB 274

SOURCES OF INFORMATION

Responses Received From

Retiree Health Care Authority (RHCA)

Department of Health (DOH)

Health Policy Commission (HPC)

Public Regulation Commission (PRC)

SUMMARY

Synopsis of Bill

House Bill 265 amends the Health Maintenance Law of the New Mexico Insurance Code, NMSA 1978, §59A-46-36. HB 265 prohibits Health Maintenance Organizations (HMO) from discriminating against Doctors of Oriental Medicine (acupuncturists) relative to other providers regarding reimbursement levels and services provided within the scope of their practice.

Significant Issues

DOH states that HB 265 requires reimbursement parity on the basis of the title, Doctor of Oriental Medicine without regard to the nature, duration or extent of training or experience.

Opponents of HB 265 claim that most HMOs already cover acupuncture treatment and that it is not appropriate for the state to limit the contractual negotiations between a health plan and a provider.

Proponents of HB 265 argue that New Mexico patients should be able to take full advantage of alternative and complimentary treatment options.

FISCAL IMPLICATIONS

There is no direct fiscal implication, but opponents from the insurance industry believe that the requirements of HB 265 will cause premiums to rise since acupuncturist fees will increase. This will impact the state’s health plans for the state employees, the public school employees and the retirees. Currently acupuncture is covered by these plans, but there is a $1500 cap that will be removed by the non-discrimination provisions of HB 265.

ADMINISTRATIVE IMPLICATIONS

HB 265 will require the Form Filing Unit of the Life & Health Bureau of the PRC to review and process amended filings by insurers requiring acupuncture coverage. The Form Filing Unit will also have to ensure that the industry is aware of this new mandated benefit and ensure compliance with the provisions of HB 265.

The Risk Management Division of the General Services Department, the Public School Insurance Authority and the RHCA will have to amend their existing health plans, but this will not require any additional resources.

DUPLICATION/RELATIONSHIP

Duplicates SB 371.

Relates to duplicate bills, HB 266 and SB 274, Reimbursement of Doctors of Oriental Medicine, that provide for Doctors of Oriental Medicine to be recognized as providers in the Medicaid program and that reimbursement rates be established.

DW/prr