reglab/housing_qa huggingface dataset:
NM Stat § 59A-46-18 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-18 - Powers of insurers.

A. An authorized insurer may either directly or through a subsidiary or affiliate organize and operate a health maintenance organization under the provisions of the Health Maintenance Organization Law. Notwithstanding any other law that may be inconsistent with the cited law, any two or more such insurance companies, or subsidiaries or affiliates thereof, may jointly organize and operate a health maintenance organization. The business of insurance is deemed to include the providing of health care by a health maintenance organization owned or operated by an insurer or a subsidiary thereof. B. An authorized insurer may contract with a health maintenance organization to provide insurance or similar protection against the cost of care provided through health maintenance organizations and to provide coverage in the event of the failure of the health maintenance organization to meet its obligations. Among other things, under such contracts the insurer may make benefit payments to health maintenance organizations for health care services rendered by providers. History: 1978 Comp., § 59A-46-18, enacted by Laws 1993, ch. 266, § 18. ANNOTATIONSRepeals and reenactments. — Laws 1993, ch. 266, § 43 repealed former 59A-46-18 NMSA 1978, as enacted by Laws 1984, ch. 127, § 865, related to rehabilitation, liquidation, or conservation of health maintenance organizations, and Laws 1993, ch. 266, § 18 enacted a new section, effective January 1, 1994.
NM Stat § 59A-46-19 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-19 - Examinations.

A. The superintendent may make an examination of the affairs of any health maintenance organization and providers with whom such organization has contracts, agreements or other arrangements as often as is reasonably necessary for the protection of the interests of the people of this state but not less frequently than once every three years. B. The superintendent may make or request the secretary of health to make an examination concerning the quality assurance program of the health maintenance organization and of any providers with whom such organization has contracts, agreements or other arrangements as often as is reasonably necessary for the protection of the interests of the people of this state. C. Every health maintenance organization and provider shall submit its books and records for such examinations and in every way facilitate the completion of the examination. Medical records of individuals and contract providers shall not be subject to such examination. For the purpose of examinations, the superintendent and the secretary of health may administer oaths to and examine the officers and agents of the health maintenance organization and the principals of such providers concerning their business. D. The expenses of examinations under this section shall be assessed against the health maintenance organization being examined and remitted to the superintendent. E. In lieu of such examination, the superintendent may accept the report of an examination made by the superintendent or secretary of health of another state. F. Examination procedures shall be governed by the applicable provisions of Chapter 59A, Article 4 NMSA 1978. History: 1978 Comp., § 59A-46-19, enacted by Laws 1993, ch. 266, § 19. ANNOTATIONSRepeals and reenactments. — Laws 1993, ch. 266, § 43 repealed former 59A-46-19 NMSA 1978, as enacted by Laws 1984, ch. 127, § 866, related to regulations, and Laws 1993, ch. 266, § 19 enacted a new section, effective January 1, 1994.
NM Stat § 59A-46-21 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-21 - Rehabilitation, liquidation or conservation of health maintenance organizations.

A. Any rehabilitation, liquidation or conservation of a health maintenance organization shall be deemed to be the rehabilitation, liquidation or conservation of an insurer and shall be conducted under the supervision of the superintendent pursuant to the law governing the rehabilitation, liquidation or conservation of insurers. The superintendent may apply for an order directing him to rehabilitate, liquidate or conserve a health maintenance organization upon any one or more grounds set out in Chapter 59A, Article 41 NMSA 1978 or when in his opinion the continued operation of the health maintenance organization would be hazardous either to the enrollees or to the people of this state. Enrollees shall have the same priority in the event of liquidation or rehabilitation as the law provides to policyholders of an insurer. B. For purpose of determining the priority of distribution of general assets, claims of enrollees and enrollees' beneficiaries shall have the same priority as established by Subsection C of Section 59A-41-44 NMSA 1978 for policyholders and beneficiaries of insureds of insurance companies. If an enrollee is liable to any provider for services provided pursuant to and covered by the health care plan, that liability shall have the status of an enrollee claim for distribution of general assets. C. Any provider who is obligated by statute or agreement to hold enrollees harmless from liability for services provided pursuant to and covered by a health care plan shall have a priority of distribution of the general assets immediately following that of enrollees and enrollees' beneficiaries as described in Subsection B of this section and immediately preceding the priority of distribution described in Subsection D of Section 59A-41-44 NMSA 1978. History: 1978 Comp., § 59A-46-21, enacted by Laws 1993, ch. 266, § 21. ANNOTATIONSRepeals and reenactments. — Laws 1993, ch. 266, § 43 repealed former 59A-46-21 NMSA 1978, as enacted by Laws 1984, ch. 127, § 868, related to fees, and Laws 1993, ch. 266, § 21 enacted a new section, effective January 1, 1994.
NM Stat § 59A-46-22 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-22 - Summary orders and supervision.

A. Whenever the superintendent determines that the financial condition of any health maintenance organization is such that its continued operation might be hazardous to its enrollees, creditors or the general public, or that it has violated any provision of the Health Maintenance Organization Law, he may, after notice and hearing, order the health maintenance organization to take such action as may be reasonably necessary to rectify such condition or violation, including but not limited to one or more of the following: (1) reduce the total amount of present and potential liability for benefits by reinsurance or other method acceptable to the superintendent; (2) reduce the volume of new business being accepted; (3) reduce expenses by specified methods; (4) suspend or limit the writing of new business for a period of time; (5) increase the health maintenance organization's capital and surplus by contribution; or (6) take such other steps as the superintendent may deem appropriate under the circumstances, including suspension or revocation of the certificate or authority or assessment of administrative penalties as provided in Section 59A-46-20 NMSA 1978. B. For purposes of this section, the violation by a health maintenance organization of any law of this state to which such health maintenance organization is subject shall be deemed a violation of the provisions of the Health Maintenance Organization Law. C. The superintendent is authorized to make rules and regulations setting uniform standards and criteria for early warning that the continued operation of any health maintenance organization might be hazardous to its enrollees, creditors or the general public and setting standards for evaluating the financial condition of any health maintenance organization, which standards shall be consistent with the purposes expressed in Subsection A of this section. D. The remedies and measures available to the superintendent under this section shall be in addition to, and not in lieu of, the remedies and measures available to the superintendent under the provisions of Chapter 59A, Article 41 NMSA 1978. History: Laws 1993, ch. 266, § 22. ANNOTATIONSRepeals. — Laws 1991, ch. 9, § 45 repealed former 59A-46-22 NMSA 1978, as amended by Laws 1988, ch. 75, § 2, relating to premium tax, effective July 1, 1993.
NM Stat § 59A-46-22.1 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-22.1 - Repealed.

ANNOTATIONSRepeals. — Laws 1991, ch. 9, § 45 repealed 59A-46-22.1 NMSA 1978, as enacted by Laws 1988, ch. 75, § 2, relating to supplemental premium tax, effective July 1, 1993. For provisions of former section, see the 1990 NMSA 1978 on NMOneSource.com.
NM Stat § 59A-46-23 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-23 - Regulations.

The superintendent may, after notice and hearing, adopt and promulgate reasonable rules and regulations as are necessary or proper to carry out the provisions of the Health Maintenance Organization Law. History: 1978 Comp., § 59A-46-23, enacted by Laws 1993, ch. 266, § 23. ANNOTATIONSRepeals and reenactments. — Laws 1993, ch. 266, § 43 repealed former 59A-46-23 NMSA 1978, as enacted by Laws 1984, ch. 127, § 870, related to penalties and enforcement, and Laws 1993, ch. 266, § 23 enacted a new section, effective January 1, 1994.
NM Stat § 59A-46-24 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-24 - Fees.

Every health maintenance organization subject to the provisions of the Health Maintenance Organization Law shall pay to the superintendent all applicable fees specified in Section 59A-6-1 NMSA 1978. History: 1978 Comp., § 59A-46-24, enacted by Laws 1993, ch. 266, § 24. ANNOTATIONSRepeals and reenactments. — Laws 1993, ch. 266, § 43 repealed former 59A-46-24 NMSA 1978, as amended by Laws 1991, ch. 111, § 14, related to statutory construction and relationship to other laws, and Laws 1993, ch. 266, § 24 enacted a new section, effective January 1, 1994.
NM Stat § 59A-46-26 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-26 - Filings and reports as public documents.

All applications, filings and reports required under the Health Maintenance Organization Law shall be treated as public documents, except those that are trade secrets or privileged or confidential quality assurance, commercial or financial information, other than any annual financial statement that may be required under Section 59A-46-9 NMSA 1978. History: 1978 Comp., § 59A-46-26, enacted by Laws 1993, ch. 266, § 26. ANNOTATIONSRepeals and reenactments. — Laws 1993, ch. 266, § 43 repealed former 59A-46-26 NMSA 1978, as enacted by Laws 1984, ch. 127, § 873, related to confidentiality of health information, and Laws 1993, ch. 266, § 26 enacted a new section, effective January 1, 1994.
NM Stat § 59A-46-26.1 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-26.1 - Employer utilization and loss experience availability.

Employer claims information, including utilization and loss experience under health insurance provided under Chapter 59A, Article 46 NMSA 1978 shall be made available by the carrier only upon the written request of and to employers of enrollees with such coverage within thirty days of an employer's written request for such information to the carrier, provided the employer's coverage extends to no less than twenty-five individual enrollees, regardless of whether family coverage is included. Each carrier shall provide to the employer claims information that provides sufficient detail, subject to state and federal privacy laws, to enable the employer to obtain and compare rates from multiple carriers or establish a plan of self-insurance. History: Laws 2003, ch. 252, § 4; 2007, ch. 53, § 2. ANNOTATIONSThe 2007 amendment, effective June 15, 2007, required insurers to provide claims experience information to employers to permit the employer to obtain and compare group health care rates and coverage from other carriers.
NM Stat § 59A-46-28 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-28 - Authority to contract.

The secretary of health, in carrying out his obligations as requested by the superintendent under the provisions of the Health Maintenance Organization Law, may contract with qualified persons to make recommendations concerning the determinations required to be made by him, which recommendations may be accepted in full or in part or rejected entirely. History: 1978 Comp., § 59A-46-28, enacted by Laws 1993, ch. 266, § 28. ANNOTATIONSRecompilations. — Laws 1993, ch. 266, § 31, recompiled former 59A-46-28 NMSA 1978, as enacted by Laws 1984, ch. 127, § 875 relating to a requirement for maternity transport coverage, as 59A-46-39 NMSA 1978, effective January 1, 1994.
NM Stat § 59A-46-31 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-31 - Coordination of benefits.

A. Health maintenance organizations are permitted, but not required, to adopt coordination of benefits provisions to avoid overinsurance and to provide for the orderly payment of claims when a person is covered by two or more group health insurance or health care plans. B. If health maintenance organizations adopt coordination of benefits, the provisions shall be consistent with the coordination of benefits provisions that are in general use in the state for coordinating coverage between two or more group health insurance or health care plans. C. To the extent necessary for health maintenance organizations to meet their obligations as secondary carriers under the regulations established by the superintendent, health maintenance organizations shall make payments for services that are: (1) received from non-participating providers; (2) provided outside their service areas; or (3) not covered under the terms of their group contracts or evidence of coverage. History: 1978 Comp., § 59A-46-31, enacted by Laws 1993, ch. 266, § 30. ANNOTATIONSRepeals and reenactments. — Laws 1993, ch. 266, § 43 repealed former 59A-46-31 NMSA 1978, as enacted by Laws 1984, ch. 127, § 877, related to contractual relations, and Laws 1993, ch. 266, § 30 enacted a new section, effective January 1, 1994.
NM Stat § 59A-46-32.1 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-32.1 - Recompiled.

ANNOTATIONSRecompilations. — Laws 1993, ch. 266, § 31, recompiled 59A-46-32.1 NMSA 1978, as enacted by Laws 1989, ch. 96, § 2, relating to prohibition of acupuncture practitioner discrimination, as 59A-46-36 NMSA 1978, effective January 1, 1994.
NM Stat § 59A-46-33 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-33 - Governing body.

The governing body of any health maintenance organization may include providers or other individuals, or both. Such governing body shall establish a mechanism to afford the enrollees an opportunity to participate in matters of policy and operation through the establishment of advisory panels, by the use of advisory referenda on major policy decisions or through the use of other mechanisms. History: Laws 1984, ch. 127, § 853; 1978 Comp., § 59A-46-6, recompiled as 1978 Comp., § 59A-46-33 by Laws 1993, ch. 266, § 31. ANNOTATIONSRecompilations. — Laws 1993, ch. 266, § 31, recompiled former 59A-46-33 NMSA 1978, as enacted by Laws 1988, ch. 89, § 2, relating to coverage for adopted children, as 59A-46-37 NMSA 1978, effective January 1, 1994.
NM Stat § 59A-46-34 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-34 - Prohibited practices.

A. No health maintenance organization, or representative thereof, may cause or knowingly permit the use of advertising which is untrue or misleading, solicitation which is untrue or misleading, or any form of evidence of coverage which is deceptive. For purposes of this article: (1) a statement or item of information is deemed to be untrue if it does not conform to fact in any respect which is or may be significant to an enrollee of, or person considering enrollment in a health maintenance organization; (2) a statement or item of information is deemed to be misleading, whether or not it may be literally untrue, if, in the total context in which such statement is made or such item of information is communicated, such statement or item of information may be reasonably understood by a reasonable person, not possessing special knowledge regarding health care coverage, as indicating any benefit or advantage or the absence of any exclusion, limitation or disadvantage of possible significance to an enrollee of, or person considering enrollment in, a health maintenance organization, if such benefit or advantage or absence of limitation, exclusion, or disadvantage does not in fact exist; and (3) an evidence of coverage is deemed to be deceptive if the evidence of coverage taken as a whole, and with consideration given to typography and format, as well as language, shall be such as to cause a reasonable person, not possessing special knowledge regarding health care coverage and evidences of coverage therefor, to expect benefits, services, charges, or other advantages which the evidence of coverage does not provide or which the health maintenance organization issuing such evidence of coverage does not regularly make available for enrollees covered under such evidence of coverage. B. An enrollee may not be canceled or nonrenewed on the basis of the status of his health. C. No health maintenance organization, unless licensed as an insurer, may use in its name, contracts or literature any of the words "insurance," "casualty," "surety," "mutual" or any other words descriptive of the insurance, casualty or surety business if such words are used in a manner to imply that such coverages are being illegally offered by the health maintenance organization or if deceptively similar to the name or description of any insurance or surety corporation doing business in the state. D. Any person not in possession of a valid certificate of authority issued pursuant to this article shall not use the phrase "health maintenance organization" or "HMO" in the course of operation. History: Laws 1984, ch. 127, § 860; 1978 Comp., § 59A-46-13, recompiled as 1978 Comp., § 59A-46-34 by Laws 1993, ch. 266, § 31. ANNOTATIONSRecompilations. — Laws 1993, ch. 266, § 31, recompiled former 59A-46-34 NMSA 1978, as enacted by Laws 1989, ch. 183, § 6, relating to individuals eligible for medicaid, as 59A-46-29 NMSA 1978, effective January 1, 1994.
NM Stat § 59A-46-35 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-35 - Provider discrimination prohibited.

No class of licensed individual providers willing to meet the terms and conditions offered by a health maintenance organization shall be excluded from a health maintenance organization. For purposes of this section, "providers" means those persons licensed pursuant to: A. the Optometry Act [Chapter 61, Article 2 NMSA 1978]; B. Section 61-3-23.2 NMSA 1978; C. the Chiropractic Physician Practice Act [Chapter 61, Article 4 NMSA 1978]; D. the Dental Health Care Act [Chapter 61, Article 5A NMSA 1978]; E. the Medical Practice Act [Chapter 61, Article 6 NMSA 1978]; F. the Podiatry Act [Chapter 61, Article 8 NMSA 1978]; G. the Professional Psychologist Act [Chapter 61, Article 9 NMSA 1978]; H. Chapter 61, Article 10 NMSA 1978; or I. the Pharmacy Act [Chapter 61, Article 11 NMSA 1978]. History: 1978 Comp., § 59A-46-32, enacted by Laws 1987, ch. 335, § 1; 1989, ch. 55, § 1; recompiled as 1978 Comp., § 59A-46-35 by Laws 1993, ch. 266, § 31; 1998, ch. 39, § 1; 2003, ch. 343, § 3. ANNOTATIONSRecompilations. — Laws 1993, ch. 266, § 31, recompiled former 59A-46-35 NMSA 1978, as enacted by Laws 1990, ch. 5, § 1, relating to coverage for mammograms, as 59A-46-41 NMSA 1978, effective January 1, 1994. The 2003 amendment, effective June 20, 2003, changed references to the chapter and article to the named acts in Subsections A through I. The 1998 amendment, effective May 20, 1998, substituted "pursuant to Section 61-3-23.2 NMSA 1978 or Article" for "under Articles" and "5A" for "5" near the end of the section.
NM Stat § 59A-46-36 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-36 - Doctor of oriental medicine; discrimination prohibited.

Doctors of oriental medicine as a class of licensed providers willing to meet the terms and conditions offered by a health maintenance organization shall not be excluded from a health maintenance organization and shall not be discriminated against relative to other classes of licensed providers regarding services provided within their scope of practice that are in compliance with nationally recognized coding systems. Health maintenance organizations may determine the specific procedure codes that a doctor of oriental medicine is contracted to provide. Health maintenance organizations may choose to contract a doctor of oriental medicine as a primary care provider. History: Laws 1989, ch. 96, § 2; 1993, ch. 158, § 4; 1978 Comp., § 59A-46-32.1, recompiled as 1978 Comp., § 59A-46-36 by Laws 1993, ch. 266, § 31; 2003, ch. 96, § 1. ANNOTATIONSRecompilations. — Laws 1993, ch. 266, § 31, recompiled former 59A-46-36 NMSA 1978, as enacted by Laws 1992, ch. 56, § 1, relating to coverage for cytologic screening, as 59A-46-42 NMSA 1978, effective January 1, 1994. Cross references. — For prohibition of discrimination against oriental medical doctors, see 59A-47-28.2 NMSA 1978. The 2003 amendment, effective June 20, 2003, inserted "and shall not be discriminated against relative to other classes of licensed providers regarding services provided within their scope of practice that are in compliance with nationally recognized coding systems." following "health maintenance organization" and added the last two sentences. The 1993 amendment, effective June 18, 1993, substituted "Doctor of Oriental Medicine" for "Acupuncture Practitioner" in the section heading and substituted "Doctors of oriental medicine" for "Acupuncture practitioners" at the beginning of the section.
NM Stat § 59A-46-37 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-37 - Coverage for adopted children.

A. No individual or group health maintenance organization contract shall be offered, issued or renewed in New Mexico on or after July 1, 1988, unless the contract covers adopted children of the subscriber or enrollee on the same basis as other dependents. B. The coverage required by this section is effective from the date of placement for the purpose of adoption and continues unless the placement is disrupted prior to legal adoption and the child is removed from placement. Coverage shall include the necessary care and treatment of medical conditions existing prior to the date of placement. C. As used in this section, "placement" means in the physical custody of the adoptive parent. History: 1978 Comp., § 59A-46-33, enacted by Laws 1988, ch. 89, § 2; recompiled as 1978 Comp., § 59A-46-37 by Laws 1993, ch. 266, § 31.