SENATE BILL 193

47th legislature - STATE OF NEW MEXICO - first session, 2005

INTRODUCED BY

Phil A. Griego

AN ACT

RELATING TO INSURANCE; REQUIRING ASSIGNMENT OF HEALTH CARE CLAIMS TO PROVIDERS.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

     Section 1. A new section of Chapter 59A, Article 16 NMSA 1978 is enacted to read:

     "[NEW MATERIAL] ASSIGNMENT OF HEALTH CLAIMS.--

          A. As used in this section:

                (1) "assignment" means the transfer from a patient of the right to collect a claim payment to the provider who rendered the treatment, good or service;

                (2) "claim" means a demand for payment that identifies a treatment, good or service as reimbursable under the health care plan; and

                (3) "health care plan" means a program that provides hospital, surgical or medical expenses benefits to subscribers or their dependents, as defined by the terms of the plan, directly through insurance, reimbursement or other means.

          B. An insurer shall not refuse to honor an assignment of a claim under a health care plan. An insurance policy or contract issued or renewed after June 30, 2005 shall not contain a restriction on the insured's right to assign a claim to a provider of health care services.

          C. Claims shall be paid on the basis of assignment to the provider of the health care service. The provider shall not collect any payment from the patient except a co-payment, coinsurance, deductible or other amount for which the patient is liable under the health care plan.

          D. Claims shall be paid pursuant to Section

59A-16-21.1 NMSA 1978."

     Section 2. EFFECTIVE DATE.--The effective date of the provisions of this act is July 1, 2005.

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