HOUSE BILL 384

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

INTRODUCED BY

James G. Townsend

AN ACT

RELATING TO HEALTH COVERAGE; AMENDING A SECTION OF THE NEW MEXICO HEALTH INSURANCE EXCHANGE ACT TO PROVIDE A MEDICAID MANAGED-CARE PAYMENT EXEMPTION FROM CARRIER ASSESSMENTS.

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

     SECTION 1. Section 59A-23F-4 NMSA 1978 (being Laws 2013, Chapter 54, Section 4) is amended to read:

     "59A-23F-4. BOARD OF DIRECTORS--POWERS.--

          A. The board may:

                [A.] (1) seek and receive grant funding from federal, state or local governments or private philanthropic organizations to defray the costs of operating the exchange;

                [B.] (2) generate funding, including charging assessments or fees, to support its operations in accordance with provisions of the New Mexico Health Insurance Exchange Act solely for the reasonable administrative costs of the exchange; provided that no assessment or user fee shall be imposed upon a carrier that exclusively offers policies, plans or contracts outside the exchange intended to supplement major medical coverage, including medicare supplement, long-term care, disability income, specified disease, accident-only, hospital indemnity or other limited-benefit health insurance policy; provided that revenue from medicaid managed-care payments shall not be used as a basis for calculating a carrier's assessment;

                [C.] (3) establish a Native American service center to ensure that the exchange:

                     [(1)] (a) is accessible to Native Americans;

                     [(2)] (b) complies with the provisions of the federal Indian Health Care Improvement Act and Indian-specific provisions of the federal Patient Protection and Affordable Care Act; and

                     [(3)] (c) facilitates meaningful, ongoing consultation with Native Americans;

                [D.] (4) create ad hoc advisory councils;

                [E.] (5) request assistance from other boards, commissions, departments, agencies and organizations as necessary to provide appropriate expertise to accomplish the exchange's duties;

                [F.] (6) enter into contracts with persons or other organizations as necessary or proper to carry out the provisions and purposes of the New Mexico Health Insurance Exchange Act, including the authority to contract or employ staff for the performance of administrative, legal, actuarial, accounting and other functions; provided that no contractor shall be a health insurance issuer or a producer;

                [G.] (7) enter into contracts with similar exchanges of other states for the joint performance of common administrative functions;

                [H.] (8) enter into information-sharing agreements with federal and state agencies and other state exchanges to carry out its responsibilities; provided that these agreements include adequate protections of the confidentiality of the information to be shared and comply with all state and federal laws and regulations;

                [I.] (9) sue or be sued or otherwise take any necessary or proper legal action in the execution of its duties and powers;

                [J.] (10) appoint board committees, which may include non-board members, to provide technical assistance in the operation of the exchange and any other function within the authority of the exchange; and

                [K.] (11) conduct periodic audits to assure the general accuracy of the financial data submitted to the exchange.

          B. As used in this section:

                (1) "medicaid" means the federal-state program administered by the human services department pursuant to Title 19 or Title 21 of the federal Social Security Act; and

                (2) "medicaid managed-care payment" means a per capita payment that the human services department makes to a carrier to provide health care benefits and services through a statewide, managed care system to provide cost-efficient, preventive, primary and acute care to medicaid recipients pursuant to Section 27-2-12.6 NMSA 1978."

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