HOUSE HEALTH AND HUMAN SERVICES COMMITTEE SUBSTITUTE FOR

HOUSE BILL 216

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

AN ACT

RELATING TO HEALTH COVERAGE; ENACTING SECTIONS OF THE HEALTH CARE PURCHASING ACT, PUBLIC ASSISTANCE ACT, CHAPTER 59A, ARTICLES 22 AND 23 NMSA 1978, THE HEALTH MAINTENANCE ORGANIZATION LAW AND THE NONPROFIT HEALTH CARE PLAN LAW TO BAN DISCRIMINATION AGAINST PROFESSIONAL ART THERAPISTS.

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] PROFESSIONAL ART THERAPISTS--BAN ON DISCRIMINATION.-- 

          A. If a group health plan covers services that are within the scope of practice of professional art therapists, the group health plan shall not discriminate against professional art therapists and shall treat professional art therapists like any other mental health practitioner for purposes of credentialing and contracting as participating providers. 

          B. The provisions of this section shall not be construed to prevent a group health plan from establishing varying reimbursement rates among mental health care practitioners based on quality or performance measures.

          C. As used in this section:

                (1) "mental health care practitioner" means an individual licensed to provide health care pursuant to the Counseling and Therapy Practice Act;

                (2) "participating provider" means a mental health care practitioner or other who, under an express contract with a group health plan or with its contractor or subcontractor, has agreed to provide health care services to enrollees with an expectation of receiving payment, other than copayment or deductible, directly or indirectly from the group health plan; and

                (3) "professional art therapist" means an individual licensed as a professional art therapist pursuant to the Counseling and Therapy Practice Act."

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

     "[NEW MATERIAL] PROFESSIONAL ART THERAPISTS--BAN ON DISCRIMINATION.--

          A. The secretary shall ensure that a medical assistance plan that covers services that are within the scope of practice of professional art therapists does not discriminate against professional art therapists and shall treat professional art therapists like any other mental health practitioner for purposes of credentialing and contracting as participating providers.

          B. The provisions of this section shall not be construed to prevent a medical assistance plan from establishing varying reimbursement rates among health care practitioners based on quality or performance measures.

          C. As used in this section:

                (1) "mental health care practitioner" means an individual licensed to provide health care pursuant to the Counseling and Therapy Practice Act;

                (2) "participating provider" means a mental health care practitioner or other provider who, under an express contract with the department, a managed care organization or with a contractor or subcontractor of the department or a managed care organization, has agreed to provide health care services to recipients with an expectation of receiving payment, other than copayment or deductible, directly or indirectly from the department or managed care organization; and

                (3) "professional art therapist" means an individual licensed as a professional art therapist pursuant to the Counseling and Therapy Practice Act."

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

     "[NEW MATERIAL] PROFESSIONAL ART THERAPISTS--BAN ON DISCRIMINATION.--

          A. An individual health insurance plan, policy or certificate of insurance that covers services that are within the scope of practice of professional art therapists shall not discriminate against professional art therapists and shall treat professional art therapists like any other mental health practitioner for purposes of credentialing and contracting as participating providers.

          B. The provisions of this section shall not be construed to prevent an insurer from establishing varying reimbursement rates among mental health care practitioners based on quality or performance measures.

          C. As used in this section:

                (1) "mental health care practitioner" means an individual licensed to provide health care pursuant to the Counseling and Therapy Practice Act;

                (2) "participating provider" means a mental health care practitioner or other provider who, under an express contract with an insurer or with its contractor or subcontractor, has agreed to provide health care services to insureds with an expectation of receiving payment, other than copayment or deductible, directly or indirectly from the insurer; and

                (3) "professional art therapist" means an individual licensed as a professional art therapist pursuant to the Counseling and Therapy Practice Act."

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

     "[NEW MATERIAL] PROFESSIONAL ART THERAPISTS--BAN ON DISCRIMINATION.--

          A. A group or blanket health insurance plan, policy or certificate of insurance that covers services that are within the scope of practice of professional art therapists shall not discriminate against professional art therapists and shall treat professional art therapists like any other mental health practitioner for purposes of credentialing and contracting as participating providers.

          B. The provisions of this section shall not be construed to prevent an insurer from establishing varying reimbursement rates among mental health care practitioners based on quality or performance measures.

          C. As used in this section:

                (1) "health care practitioner" means an individual licensed to provide health care pursuant to the Counseling and Therapy Practice Act;

                (2) "participating provider" means a mental health care practitioner or other provider who, under an express contract with an insurer or with its contractor or subcontractor, has agreed to provide health care services to insureds with an expectation of receiving payment, other than copayment or deductible, directly or indirectly from the insurer; and

                (3) "professional art therapist" means an individual licensed as a professional art therapist pursuant to the Counseling and Therapy Practice Act."

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

     "[NEW MATERIAL] PROFESSIONAL ART THERAPISTS--BAN ON DISCRIMINATION.--

          A. Health coverage provided pursuant to an individual or group health maintenance organization contract that covers services that are within the scope of practice of professional art therapists shall not discriminate against professional art therapists and shall treat professional art therapists like any other mental health practitioner for purposes of credentialing and contracting as participating providers.

          B. The provisions of this section shall not be construed to prevent a health maintenance organization from establishing varying reimbursement rates among health care practitioners based on quality or performance measures.

          C. As used in this section:

                (1) "mental health care practitioner" means an individual licensed to provide health care pursuant to the Counseling and Therapy Practice Act; and

                (2) "professional art therapist" means an individual licensed as a professional art therapist pursuant to the Counseling and Therapy Practice Act."

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

     "[NEW MATERIAL] PROFESSIONAL ART THERAPISTS--BAN ON DISCRIMINATION.--

          A. An individual or group nonprofit health care plan that covers services that are within the scope of practice of professional art therapists shall not discriminate against professional art therapists and shall treat professional art therapists like any other mental health practitioner for purposes of credentialing and contracting as participating providers.

          B. The provisions of this section shall not be construed to prevent a health care plan from establishing varying reimbursement rates among health care practitioners based on quality or performance measures.

          C. As used in this section:

                (1) "mental health care practitioner" means an individual licensed to provide health care pursuant to the Counseling and Therapy Practice Act;

                (2) "participating provider" means a mental health care practitioner or other provider who, under an express contract with a health care plan or with its contractor or subcontractor, has agreed to provide health care services to subscribers with an expectation of receiving payment, other than copayment or deductible, directly or indirectly from the health care plan; and

                (3) "professional art therapist" means an individual licensed as a professional art therapist pursuant to the Counseling and Therapy Practice Act."

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