HOUSE BILL 59

54th legislature - STATE OF NEW MEXICO - first session, 2019

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 AND THE NEW MEXICO INSURANCE CODE 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. The provisions of this section apply to group health plans delivered or issued for delivery after January 1, 2020.

          D. 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 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 the New Mexico Insurance Code is enacted to read:

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

          A. An individual or group health 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 an insurer from establishing varying reimbursement rates among mental health care practitioners based on quality or performance measures.

          C. The provisions of this section apply to the following types of health benefit plans delivered or issued for delivery after January 1, 2020:

                (1) an individual or group health insurance policy or plan or certificate of health insurance regulated in accordance with the provisions of Article 22 or 23 of the New Mexico Insurance Code;

                (2) a health maintenance organization contract regulated in accordance with the provisions of the Health Maintenance Organization Law; and

                (3) a nonprofit health care plan regulated in accordance with the provisions of the Nonprofit Health Care Plan Law.

          D. As used in this section:

                (1) "health benefit plan" means a health insurance policy, health care plan, certificate of health insurance, health maintenance organization contract or nonprofit health care plan contract delivered or issued for delivery in this state;

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

                (3) "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

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