HOUSE BILL 11

53rd legislature - STATE OF NEW MEXICO - first session, 2017

INTRODUCED BY

Christine Trujillo

FOR THE LEGISLATIVE HEALTH AND HUMAN SERVICES COMMITTEE

AN ACT

RELATING TO HEALTH COVERAGE; ENACTING SECTIONS OF THE HEALTH CARE PURCHASING ACT, THE PUBLIC ASSISTANCE ACT, THE NEW MEXICO INSURANCE CODE, THE HEALTH MAINTENANCE ORGANIZATION LAW AND THE NONPROFIT HEALTH CARE PLAN LAW TO REQUIRE COVERAGE OF ARTERY CALCIFICATION SCREENING FOR EARLY DETECTION OF CARDIOVASCULAR DISEASE IN CERTAIN INDIVIDUALS.

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

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

     "[NEW MATERIAL] ARTERY CALCIFICATION SCREENING COVERAGE.--

          A. Group health coverage, including any form of self-insurance, offered, issued or renewed under the Health Care Purchasing Act shall provide coverage for eligible enrollees to receive artery calcification screening.

          B. Coverage provided pursuant to this section shall:

                (1) be limited to the provision of an artery calcification screening to an eligible enrollee once every five years; and

                (2) not be subject to a deductible.

          C. The provisions of this section shall not apply to short-term travel, accident-only or limited or specified-disease policies, plans or certificates of health insurance.

D. As used in this section:

                (1) "artery calcification screening" means a computed tomography scan measuring coronary artery calcification for atheroscleroris and abnormal artery structure and function; and

                (2) "eligible enrollee" means an enrollee:

                     (a) who is: 1) a male older than thirty years of age and younger than seventy-six years of age; or 2) a female older than forty years of age and younger than seventy-six years of age; and

                     (b) who has a risk of developing coronary heart disease based on at least one of the following: hypertension, hyperlipidemia, diabetes, smoking or family history of heart disease."

     SECTION 2. A new section of the Public Assistance Act is enacted to read:

     "[NEW MATERIAL] ARTERY CALCIFICATION SCREENING COVERAGE.--

          A. By January 1, 2018 and in accordance with federal law, the secretary shall adopt and promulgate rules that provide medicaid coverage for eligible recipients to receive artery calcification screening.

          B. Medicaid coverage provided pursuant to this section shall be limited to the provision of an artery calcification screening to an eligible recipient once every five years.

          C. As used in this section:

                (1) "artery calcification screening" means a computed tomography scan measuring coronary artery calcification for atheroscleroris and abnormal artery structure and function; and

                (2) "eligible recipient" means a recipient:

                     (a) who is: 1) a male older than thirty years of age and younger than seventy-six years of age; or 2) a female older than forty years of age and younger than seventy-six years of age; and

                     (b) who has a risk of developing coronary heart disease based on at least one of the following: hypertension, hyperlipidemia, diabetes, smoking or family history of heart disease."

     SECTION 3. A new section of Chapter 59A, Article 22 NMSA 1978 is enacted to read:

     "[NEW MATERIAL] ARTERY CALCIFICATION SCREENING COVERAGE.--

          A. An individual or group health insurance policy, health care plan and certificate of health insurance delivered or issued for delivery in this state shall provide coverage for eligible insureds to receive artery calcification screening.

          B. Coverage provided pursuant to this section shall:

                (1) be limited to the provision of an artery calcification screening to an eligible insured once every five years; and

                (2) not be subject to a deductible.

          C. The provisions of this section do not apply to short-term travel, accident-only or limited or specified-disease policies, plans or certificates of health insurance.

          D. As used in this section:

                (1) "artery calcification screening" means a computed tomography scan measuring coronary artery calcification for atheroscleroris and abnormal artery structure and function; and

                (2) "eligible insured" means an insured:

                     (a) who is: 1) a male older than thirty years of age and younger than seventy-six years of age; or 2) a female older than forty years of age and younger than seventy-six years of age; and

                     (b) who has a risk of developing coronary heart disease based on at least one of the following: hypertension, hyperlipidemia, diabetes, smoking or family history of heart disease."

     SECTION 4. A new section of Chapter 59A, Article 23 NMSA 1978 is enacted to read:

     "[NEW MATERIAL] ARTERY CALCIFICATION SCREENING COVERAGE.--

          A. A group or blanket health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state shall provide coverage for eligible insureds to receive artery calcification screening.

          B. Coverage provided pursuant to this section shall:

                (1) be limited to the provision of an artery calcification screening to an eligible insured once every five years; and

                (2) not be subject to a deductible.

          C. The provisions of this section do not apply to short-term travel, accident-only or limited or specified-disease policies, plans or certificates of health insurance.

D. As used in this section:

                (1) "artery calcification screening" means a computed tomography scan measuring coronary artery calcification for atheroscleroris and abnormal artery structure and function; and

                (2) "eligible insured" means an insured:

                     (a) who is: 1) a male older than thirty years of age and younger than seventy-six years of age; or 2) a female older than forty years of age and younger than seventy-six years of age; and

                     (b) who has a risk of developing coronary heart disease based on at least one of the following: hypertension, hyperlipidemia, diabetes, smoking or family history of heart disease."

     SECTION 5. A new section of the Health Maintenance Organization Law is enacted to read:

     "[NEW MATERIAL] ARTERY CALCIFICATION SCREENING COVERAGE.--

          A. An individual or group health maintenance organization contract that is delivered, issued for delivery or renewed in this state shall provide coverage for eligible enrollees to receive artery calcification screening.

          B. Coverage provided pursuant to this section shall:

                (1) be limited to the provision of an artery calcification screening to an eligible enrollee once every five years; and

                (2) not be subject to a deductible.

          C. The provisions of this section do not apply to short-term travel, accident-only or limited or specified-disease policies, plans or certificates of health insurance.

          D. As used in this section:

                (1) "artery calcification screening" means a computed tomography scan measuring coronary artery calcification for atheroscleroris and abnormal artery structure and function; and

                (2) "eligible enrollee" means an enrollee:

                     (a) who is: 1) a male older than thirty years of age and younger than seventy-six years of age; or 2) a female older than forty years of age and younger than seventy-six years of age; and

                     (b) who has a risk of developing coronary heart disease based on at least one of the following: hypertension, hyperlipidemia, diabetes, smoking or family history of heart disease."

     SECTION 6. A new section of the Nonprofit Health Care Plan Law is enacted to read:

     "[NEW MATERIAL] ARTERY CALCIFICATION SCREENING COVERAGE.--          A. An individual or group health care plan that is delivered, issued for delivery or renewed in this state shall provide coverage for eligible subscribers to receive artery calcification screening.

          B. Coverage provided pursuant to this section shall:

                (1) be limited to the provision of an artery calcification screening to an eligible subscriber once every five years; and

                (2) not be subject to a deductible.

          C. The provisions of this section do not apply to short-term travel, accident-only or limited or specified- disease policies, plans or certificates of health insurance.

          D. As used in this section:

                (1) "artery calcification screening" means a computed tomography scan measuring coronary artery calcification for atheroscleroris and abnormal artery structure and function; and

                (2) "eligible subscriber" means a subscriber:

                     (a) who is: 1) a male older than thirty years of age and younger than seventy-six years of age; or 2) a female older than forty years of age and younger than seventy-six years of age; and

                     (b) who has a risk of developing coronary heart disease based on at least one of the following: hypertension, hyperlipidemia, diabetes, smoking or family history of heart disease."

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