HOUSE BILL 34

55th legislature - STATE OF NEW MEXICO - first session, 2021

INTRODUCED BY

Marian Matthews

 

 

 

FOR THE LEGISLATIVE HEALTH AND HUMAN SERVICES COMMITTEE

 

AN ACT

RELATING TO HEALTH COVERAGE; ESTABLISHING LIMITS ON COST SHARING FOR PODIATRIC SERVICES.

 

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] PODIATRIC SERVICES--LIMITS ON COST SHARING.--

          A. Group health coverage, including any form of self-insurance, offered, issued or renewed pursuant to the Health Care Purchasing Act that offers coverage of podiatric services shall not impose a member cost share for podiatric services that is greater than that for primary care services on a coinsurance percentage basis when coinsurance is applied or on an absolute dollar amount when a copay is applied.

          B. As used in this section:

                (1) "podiatric services" means the examination, diagnosis, treatment and prevention, by medical, surgical and biomechanical means, of ailments affecting the human foot and ankle and the structures governing their function; and

                (2) "primary care services" means the first level of basic or general health care for a person's health needs, including diagnostic and treatment services, initiation of referrals for other health care services and maintenance of the continuity of care when appropriate."

     SECTION 2. A new section of Chapter 59A, Article 22 NMSA 1978 is enacted to read:

     "[NEW MATERIAL] PODIATRIC SERVICES--LIMITS ON COST SHARING.--

          A. An individual or group health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state shall not impose a member cost share for podiatric services that is greater than that for primary care services on a coinsurance percentage basis when coinsurance is applied or on an absolute dollar amount when a copay is applied.

          B. As used in this section:

                (1) "podiatric services" means the examination, diagnosis, treatment and prevention, by medical, surgical and biomechanical means, of ailments affecting the human foot and ankle and the structures governing their function; and

                (2) "primary care services" means the first level of basic or general health care for a person's health needs, including diagnostic and treatment services, initiation of referrals for other health care services and maintenance of the continuity of care when appropriate."

     SECTION 3. A new section of Chapter 59A, Article 23 NMSA 1978 is enacted to read:

     "[NEW MATERIAL] PODIATRIC SERVICES--LIMITS ON COST SHARING.--

          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 not impose a member cost share for podiatric services that is greater than that for primary care services on a coinsurance percentage basis when coinsurance is applied or on an absolute dollar amount when a copay is applied.

          B. As used in this section:

                (1) "podiatric services" means the examination, diagnosis, treatment and prevention, by medical, surgical and biomechanical means, of ailments affecting the human foot and ankle and the structures governing their function; and

                (2) "primary care services" means the first level of basic or general health care for a person's health needs, including diagnostic and treatment services, initiation of referrals for other health care services and maintenance of the continuity of care when appropriate."

     SECTION 4. A new section of the Health Maintenance Organization Law is enacted to read:

     "[NEW MATERIAL] PODIATRIC SERVICES--LIMITS ON COST SHARING.--

          A. An individual or group health maintenance organization contract that is delivered, issued for delivery or renewed in this state shall not impose a member cost share for podiatric services that is greater than that for primary care services on a coinsurance percentage basis when coinsurance is applied or on an absolute dollar amount when a copay is applied.

          B. As used in this section:

                (1) "podiatric services" means the examination, diagnosis, treatment and prevention, by medical, surgical and biomechanical means, of ailments affecting the human foot and ankle and the structures governing their function; and

                (2) "primary care services" means the first level of basic or general health care for a person's health needs, including diagnostic and treatment services, initiation of referrals for other health care services and maintenance of the continuity of care when appropriate."

     SECTION 5. A new section of the Nonprofit Health Care Plan Law is enacted to read:

     "[NEW MATERIAL] PODIATRIC SERVICES--LIMITS ON COST SHARING.--

          A. An individual or group policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state shall not impose a member cost share for podiatric services that is greater than that for primary care services on a coinsurance percentage basis when coinsurance is applied or on an absolute dollar amount when a copay is applied.

          B. As used in this section:

                (1) "podiatric services" means the examination, diagnosis, treatment and prevention, by medical, surgical and biomechanical means, of ailments affecting the human foot and ankle and the structures governing their function; and

                (2) "primary care services" means the first level of basic or general health care for a person's health needs, including diagnostic and treatment services, initiation of referrals for other health care services and maintenance of the continuity of care when appropriate."

     SECTION 6. EFFECTIVE DATE.--The effective date of the provisions of this act is January 1, 2022.

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