HOUSE BILL 259

52nd legislature - STATE OF NEW MEXICO - first session, 2015

INTRODUCED BY

Jim R. Trujillo

AN ACT

RELATING TO TAXATION; EXPANDING THE TYPES OF RECEIPTS THAT MAY BE DEDUCTED FROM GROSS RECEIPTS FOR COMMERCIAL CONTRACT AND MEDICARE PART C SERVICES PROVIDED BY A PHYSICIAN, OSTEOPATHIC PHYSICIAN OR PODIATRIST; PROVIDING FOR DELAYED REPEAL.

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

     SECTION 1. Section 7-9-93 NMSA 1978 (being Laws 2004, Chapter 116, Section 6, as amended) is amended to read:

     "7-9-93. DEDUCTION--GROSS RECEIPTS--CERTAIN RECEIPTS FOR SERVICES PROVIDED BY HEALTH CARE PRACTITIONER.--

          A. The purpose of the deductions for payments made to a health care practitioner by a managed care organization or health insurer for commercial contract services or medicare part C services and for deductibles paid by an insured or enrollee to a health care practitioner pursuant to the terms of the insured's health insurance plan or enrollee's managed care health plan is to retain health care practitioners currently providing commercial contract and medicare part C services in the state and to attract additional health care practitioners to provide commercial contract and medicare part C services in New Mexico.

          [A.] B. Receipts from payments by a managed [health care provider] care organization or health care insurer for commercial contract services or medicare part C services provided by a health care practitioner [that are not otherwise deductible pursuant to another provision of the Gross Receipts and Compensating Tax Act] may be deducted from gross receipts [provided that the services are within the scope of practice of the person providing the service. Receipts from fee-for-service payments by a health care insurer may not be deducted from gross receipts. The deduction provided by this section shall be separately stated by the taxpayer].

          C. Receipts from deductibles paid by an insured or enrollee to a physician licensed pursuant to the Medical Practice Act, an osteopathic physician licensed pursuant to the provisions of Chapter 61, Article 10 NMSA 1978 or a podiatrist licensed pursuant to the provisions of the Podiatry Act for commercial contract services pursuant to the terms of the insured's health insurance plan or the enrollee's managed care health plan may be deducted from gross receipts.

          [B.] D. For the purposes of this section:

                (1) "commercial contract services" means health care services performed by a health care practitioner at negotiated fee rates pursuant to a contract with a managed [health care provider] care organization or health care insurer other than those health care services provided [for] to medicare patients pursuant to Title 18 of the federal Social Security Act or [for] to medicaid patients pursuant to Title 19 or Title 21 of the federal Social Security Act;

                (2) "deductible" means the amount of covered charges an insured or enrollee is required to pay in a plan year for commercial contract services before the insured's health insurance plan or enrollee's managed care health plan begins to pay for applicable covered charges;

                (3) "fee-for-service" means payment for health care services by a health care insurer for covered charges under an indemnity insurance plan;

                [(2)] (4) "health care insurer" means a person that:

                     (a) has a valid certificate of authority in good standing pursuant to the New Mexico Insurance Code to act as an insurer, health maintenance organization or nonprofit health care plan or prepaid dental plan; and

                     (b) contracts to reimburse licensed health care practitioners for providing basic health services to insureds or enrollees at negotiated fee rates;

                [(3)] (5) "health care practitioner" means:

                     (a) a chiropractic physician licensed pursuant to the provisions of the Chiropractic Physician Practice Act;

                     (b) a dentist or dental hygienist licensed pursuant to the Dental Health Care Act;

                     (c) a doctor of oriental medicine licensed pursuant to the provisions of the Acupuncture and Oriental Medicine Practice Act;

                     (d) an optometrist licensed pursuant to the provisions of the Optometry Act;

                     (e) an osteopathic physician licensed pursuant to the provisions of Chapter 61, Article 10 NMSA 1978 or an osteopathic physician's assistant licensed pursuant to the provisions of the Osteopathic Physicians' Assistants Act;

                     (f) a physical therapist licensed pursuant to the provisions of the Physical Therapy Act;

                     (g) a physician or physician assistant licensed pursuant to the provisions of [Chapter 61, Article 6 NMSA 1978] the Medical Practice Act;

                     (h) a podiatrist licensed pursuant to the provisions of the Podiatry Act;

                     (i) a psychologist licensed pursuant to the provisions of the Professional Psychologist Act;

                     (j) a registered lay midwife registered by the department of health;

                     (k) a registered nurse or licensed practical nurse licensed pursuant to the provisions of the Nursing Practice Act;

                     (l) a registered occupational therapist licensed pursuant to the provisions of the Occupational Therapy Act;

                     (m) a respiratory care practitioner licensed pursuant to the provisions of the Respiratory Care Act;                 

                     (n) a speech-language pathologist or audiologist licensed pursuant to the Speech-Language Pathology, Audiology and Hearing Aid Dispensing Practices Act;

                     (o) a professional clinical mental health counselor, marriage and family therapist or professional art therapist licensed pursuant to the provisions of the Counseling and Therapy Practice Act who has obtained a master's degree or a doctorate;

                     (p) an independent social worker licensed pursuant to the provisions of the Social Work Practice Act; and

                     (q) a clinical laboratory that is accredited pursuant to 42 U.S.C. Section 263a but that is not a laboratory in a physician's office or in a hospital defined pursuant to 42 U.S.C. Section 1395x;

                [(4) "managed health care provider"] (6) "managed care organization" means a person that provides for the delivery of comprehensive basic health care services and medically necessary services to individuals enrolled in a plan through its own employed health care providers or by contracting with selected or participating health care providers. "Managed [health care provider] care organization" includes only those persons that provide comprehensive basic health care services to enrollees on a contract basis, including the following:

                     (a) health maintenance organizations;

                     (b) preferred provider organizations;

                     (c) individual practice associations;

                     (d) competitive medical plans;

                     (e) exclusive provider organizations;

                     (f) integrated delivery systems;

                     (g) independent physician-provider organizations;

                     (h) physician hospital-provider organizations; and

                     (i) managed care services organizations; [and]

                (7) "managed care health plan" means a health care plan offered by a managed care organization that provides for the delivery of comprehensive basic health care services and medically necessary services to individuals enrolled in the plan other than those services provided to medicare patients pursuant to Title 18 of the federal Social Security Act or to medicaid patients pursuant to Title 19 or Title 21 of the federal Social Security Act; and

                [(5)] (8) "medicare part C services" means services performed pursuant to a contract with a managed [health care provider] care organization for medicare patients pursuant to Title 18 of the federal Social Security Act.

          E. The economic development department shall:

                (1) request the New Mexico center for health workforce analysis to collect data to be used to assess the effectiveness of the deductions authorized by this section in the retention and recruitment of health care practitioners who provide commercial contract services and medicare part C services; and

                (2) report to the interim legislative revenue stabilization and tax policy committee and to the legislative finance committee by November of each year on the effectiveness of the deductions authorized by this section in the retention and recruitment of health care practitioners who provide commercial contract services and medicare part C services.

          F. Receipts from fee-for-service payments by a health care insurer shall not be deducted from gross receipts pursuant to this section."

     SECTION 2. DELAYED REPEAL.--Section 7-9-93 NMSA 1978 (being Laws 2004, Chapter 116, Section 6, as amended by Section 1 of this act) is repealed effective January 1, 2021.

     SECTION 3. EFFECTIVE DATE.--The effective date of the provisions of this act is July 1, 2015.

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