FORTY-NINTH LEGISLATURE

FIRST SESSION, 2009

March 15, 2009

Mr. Speaker:

    Your BUSINESS AND INDUSTRY COMMITTEE, to whom has been referred

SENATE BILL 42, as amended

has had it under consideration and reports same with recommendation that it DO PASS, amended as follows:

     1. On page 1, line 11, after "AMENDING" strike the remainder of the line and strike line 12 through "CODE" and insert in lieu thereof ", REPEALING AND ENACTING SECTIONS OF THE NMSA 1978".

     2. On page 1, between lines 15 and 16, insert the following new section:

     "Section 1. A new section of the Health Care Purchasing Act is enacted to read:

     "[NEW MATERIAL] REQUIRED COVERAGE OF PATIENT COSTS INCURRED IN CANCER CLINICAL TRIALS.--Group health coverage, including any form of self-insurance, offered, issued or renewed under the Health Care Purchasing Act shall provide coverage pursuant to Section 59A-22-43 NMSA 1978 for routine patient care costs incurred as a result of the patient's participation in cancer clinical trials."".

     3. Renumber the succeeding sections accordingly.

     4. On page 8, after line 25, insert the following new sections:

     "Section 3. Section 59A-23-4 NMSA 1978 (being Laws 1984, Chapter 127, Section 463, as amended) is amended to read:

     "59A-23-4. OTHER PROVISIONS APPLICABLE.--

          A. A blanket or group health insurance policy or contract shall not contain a provision relative to notice or proof of loss or the time for paying benefits or the time within which suit may be brought upon the policy that in the superintendent's opinion is less favorable to the insured than would be permitted in the required or optional provisions for individual health insurance policies as set forth in Chapter 59A, Article 22 NMSA 1978.

          B. The following provisions of Chapter 59A, Article 22 NMSA 1978 shall also apply as to Chapter 59A, Article 23 NMSA 1978 and blanket and group health insurance contracts:

                (1) Section 59A-22-1 NMSA 1978, except Subsection C of that section; and

                (2) Section 59A-22-32 NMSA 1978.

          C. The following provisions of Chapter 59A, Article 22 NMSA 1978 shall also apply as to group health insurance contracts:

                (1) Section 59A-22-33 NMSA 1978;

                (2) Section 59A-22-34 NMSA 1978;

                (3) Section 59A-22-34.1 NMSA 1978;

                (4) Section 59A-22-34.3 NMSA 1978;

                (5) Section 59A-22-35 NMSA 1978;

                 (6) Section 59A-22-36 NMSA 1978;

                 (7) Section 59A-22-39 NMSA 1978;

                (8) Section 59A-22-39.1 NMSA 1978;

                (9) Section 59A-22-40 NMSA 1978;

                (10) Section 59A-22-40.1 NMSA 1978;

                (11) Section 59A-22-41 NMSA 1978;

                 (12) Section 59A-22-42 NMSA 1978; [and]

                (13) Section 59A-22-43 NMSA 1978; and

                [(13)] (14) Section 59A-22-44 NMSA 1978."

     Section 4. Section 59A-46-30 NMSA 1978 (being Laws 1993, Chapter 266, Section 29, as amended) is amended to read:

     "59A-46-30. STATUTORY CONSTRUCTION AND RELATIONSHIP TO OTHER LAWS.--

          A. The provisions of the Insurance Code other than Chapter 59A, Article 46 NMSA 1978 shall not apply to health maintenance organizations except as expressly provided in the Insurance Code and that article. To the extent reasonable and not inconsistent with the provisions of that article, the following articles and provisions of the Insurance Code shall also apply to health maintenance organizations and their promoters, sponsors, directors, officers, employees, agents, solicitors and other representatives. For the purposes of such applicability, a health maintenance organization may therein be referred to as an "insurer":

                (1) Chapter 59A, Article 1 NMSA 1978;

                (2) Chapter 59A, Article 2 NMSA 1978;

                (3) Chapter 59A, Article 4 NMSA 1978;

                (4) Subsection C of Section 59A-5-22 NMSA 1978;

                (5) Sections 59A-6-2 through 59A-6-4 and 59A-6-6 NMSA 1978;

                (6) Chapter 59A, Article 8 NMSA 1978;

                (7) Chapter 59A, Article 10 NMSA 1978;

                (8) Section 59A-12-22 NMSA 1978;

                (9) Chapter 59A, Article 16 NMSA 1978;

                (10) Chapter 59A, Article 18 NMSA 1978;

                (11) the Policy Language Simplification Law;

                (12) Section 59A-22-14 NMSA 1978;

                (13) the Insurance Fraud Act;

                (14) Section 59A-22-43 NMSA 1978;

                [(14)] (15) the Minimum Healthcare Protection Act;

                [(15)] (16) Sections 59A-34-2, 59A-34-7 through

59A-34-13, 59A-34-17, 59A-34-23, 59A-34-33, 59A-34-36,

59A-34-37, 59A-34-40 through 59A-34-42 and 59A-34-44 through 59A-34-46 NMSA 1978;

                [(16)] (17) The Insurance Holding Company Law; and

                [(17)] (18) the Patient Protection Act.

          B. Solicitation of enrollees by a health maintenance organization granted a certificate of authority, or its representatives, shall not be construed as violating any provision of law relating to solicitation or advertising by health professionals, but health professionals shall be individually subject to the laws, rules and ethical provisions governing their individual professions.

          C. Any health maintenance organization authorized under the provisions of the Health Maintenance Organization Law shall not be deemed to be practicing medicine and shall be exempt from the provisions of laws relating to the practice of medicine."

     Section 5. Section 59A-47-33 NMSA 1978 (being Laws 1984, Chapter 127, Section 879.32, as amended) is amended to read:

     "59A-47-33. OTHER PROVISIONS APPLICABLE.--The provisions of the Insurance Code other than Chapter 59A, Article 47 NMSA 1978 shall not apply to health care plans except as expressly provided in the Insurance Code and that article. To the extent reasonable and not inconsistent with the provisions of that article, the following articles and provisions of the Insurance Code shall also apply to health care plans, their promoters, sponsors, directors, officers, employees, agents, solicitors and other representatives; and, for the purposes of such applicability, a health care plan may therein be referred to as an "insurer":

          A. Chapter 59A, Article 1 NMSA 1978;

          B. Chapter 59A, Article 2 NMSA 1978;

          C. Chapter 59A, Article 4 NMSA 1978;

          D. Subsection C of Section 59A-5-22 NMSA 1978;

          E. Sections 59A-6-2 through 59A-6-4 and 59A-6-6 NMSA 1978;

          F. Section 59A-7-11 NMSA 1978;

          G. Chapter 59A, Article 8 NMSA 1978;

          H. Chapter 59A, Article 10 NMSA 1978;

          I. Section 59A-12-22 NMSA 1978;

          J. Chapter 59A, Article 16 NMSA 1978;

          K. Chapter 59A, Article 18 NMSA 1978;

          L. the Policy Language Simplification Law;

           M. Subsections B through E of Section 59A-22-5 NMSA 1978;

          N. Section 59A-22-14 NMSA 1978;

          O. Section 59A-22-34.1 NMSA 1978;

          P. Section 59A-22-39 NMSA 1978;

          Q. Section 59A-22-40 NMSA 1978;

          R. Section 59A-22-40.1 NMSA 1978;

          S. Section 59A-22-41 NMSA 1978;

          T. Section 59A-22-42 NMSA 1978;

          U. Section 59A-22-43 NMSA 1978;

          [U.] V. Section 59A-22-44 NMSA 1978;

          [V.] W. Sections 59A-34-7 through 59A-34-13, 59A-34-17,

59A-34-23, 59A-34-33, 59A-34-40 through 59A-34-42 and 59A-34-44 through 59A-34-46 NMSA 1978;

          [W.] X. The Insurance Holding Company Law, except Section 59A-37-7 NMSA 1978;

          [X.] Y. Section 59A-46-15 NMSA 1978; and

          [Y.] Z. the Patient Protection Act."".

     5. Renumber the succeeding section accordingly.