reglab/housing_qa huggingface dataset:
NM Stat § 59A-22-39 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-39 - Coverage for mammograms.

A. Each individual and group health insurance policy, health care plan and certificate of health insurance delivered or issued for delivery in this state shall provide coverage for low-dose screening mammograms for determining the presence of breast cancer. Such coverage shall make available one baseline mammogram to persons age thirty-five through thirty-nine, one mammogram biennially to persons age forty through forty-nine and one mammogram annually to persons age fifty and over. After July 1, 1992, coverage shall be available only for screening mammograms obtained on equipment designed specifically to perform low-dose mammography in imaging facilities that have met American college of radiology accreditation standards for mammography. B. Coverage for mammograms may be subject to deductibles and coinsurance consistent with those imposed on other benefits under the same policy, plan or certificate. C. The provisions of this section shall not apply to short-term travel, accident-only or limited or specified disease policies. History: 1978 Comp., § 59A-22-39, enacted by Laws 1990, ch. 5, § 2. ANNOTATIONSApplicability. — Laws 1990, ch. 5, § 5 made the act applicable to policies, plans, contracts and certificates delivered or issued for delivery or renewed, extended or amended in this state on or after July 1, 1990.
NM Stat § 59A-22-39.1 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-39.1 - Mastectomies and lymph node dissection; minimum hospital stay coverage required.

A. Each individual and group health insurance policy, health care plan and certificate of health insurance delivered or issued for delivery in this state shall provide coverage for not less than forty-eight hours of inpatient care following a mastectomy and not less than twenty-four hours of inpatient care following a lymph node dissection for the treatment of breast cancer. B. Nothing in this section shall be construed as requiring the provision of inpatient coverage where the attending physician and patient determine that a shorter period of hospital stay is appropriate. C. The provisions of this section shall not apply to short-term travel, accident-only or limited or specified disease policies. D. Coverage for minimum inpatient hospital stays for mastectomies and lymph node dissections for the treatment of breast cancer may be subject to deductibles and co-insurance consistent with those imposed on other benefits under the same policy, plan or certificate. History: 1978 Comp., § 59A-22-39.1, enacted by Laws 1997, ch. 249, § 1.
NM Stat § 59A-22-39.2 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-39.2 - Prior authorization for gynecological or obstetrical ultrasounds prohibited.

A. An individual or group health insurance policy, health care plan or certificate of insurance that is delivered, issued for delivery or renewed in this state and that provides coverage for gynecological or obstetrical ultrasounds shall not require prior authorization for gynecological or obstetrical ultrasounds. B. Nothing in this section shall be construed to require payment for a gynecological or obstetrical ultrasound that is not: (1) medically necessary; or (2) a covered benefit. C. As used in this section, "prior authorization" means advance approval that is required by a health insurance policy, health care plan or certificate of insurance as a condition precedent to payment for medical care or related benefits rendered to a covered person, including prospective or utilization review conducted prior to the provision of covered medical care or related benefits. History: Laws 2019, ch. 182, § 3. ANNOTATIONSEmergency clauses. — Laws 2019, ch. 182, § 7 contained an emergency clause and was approved April 3, 2019.
NM Stat § 59A-22-40 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-40 - Coverage for cytologic and human papillomavirus screening.

A. Each individual and group health insurance policy, health care plan and certificate of health insurance delivered or issued for delivery in this state shall provide coverage for cytologic and human papillomavirus screening for determining the presence of precancerous or cancerous conditions and other health problems. The coverage shall make available cytologic screening, as determined by the health care provider in accordance with national medical standards, for women who are eighteen years of age or older and for women who are at risk of cancer or at risk of other health conditions that can be identified through cytologic screening. The coverage shall make available human papillomavirus screening once every three years for women aged thirty and older. B. Coverage for cytologic and human papillomavirus screening may be subject to deductibles and coinsurance consistent with those imposed on other benefits under the same policy, plan or certificate. C. The provisions of this section shall not apply to short-term travel, accident-only or limited or specified-disease policies. D. For the purposes of this section: (1) "cytologic screening" means a Papanicolaou test and a pelvic exam for asymptomatic as well as symptomatic women; (2) "health care provider" means any person licensed within the scope of his practice to perform cytologic and human papillomavirus screening, including physicians, physician assistants, certified nurse midwives and certified nurse practitioners; and (3) "human papillomavirus screening" means a test approved by the federal food and drug administration for detection of the human papillomavirus. History: 1978 Comp., § 59A-22-40, enacted by Laws 1992, ch. 56, § 2; 2005, ch. 133, § 2. ANNOTATIONSThe 2005 amendment, effective June 17, 2005, provided in Subsection A that health insurance provide coverage for human papillomavirus and shall make available human papillomavirus screening every three years for women aged thirty and older; in Subsection B, provided that coverage for human papillomavirus screening may be subject to deductibles and coinsurance; and in Subsection D, defined "health care provider" to include any person who performs human papillomavirus screening and "human papillomavirus screening" to mean a test for detection of human papillomavirus.
NM Stat § 59A-22-40.1 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-40.1 - Coverage for the human papillomavirus vaccine.

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 provide coverage for the human papillomavirus vaccine in accordance with the current standards of the federal centers for disease control and prevention.B. Coverage for the human papillomavirus vaccine may be subject to deductibles and coinsurance consistent with those imposed on other benefits under the same policy, plan or certificate.C. The provisions of this section shall not apply to short-term travel, accident-only or limited or specified disease policies.D. For the purposes of this section, "human papillomavirus vaccine" means a vaccine approved by the federal food and drug administration used for the prevention of human papillomavirus infection and cervical precancers. History: Laws 2007, ch. 278, § 1; 2021, ch. 108, § 19. ANNOTATIONSThe 2021 amendment, effective July 1, 2021, revised age-related guidelines for coverage for the human papillomavirus; and in Subsection A, after "human papillomavirus vaccine", deleted "to females nine to fourteen years of age", and added "in accordance with the current standards of the federal centers for disease control and prevention".
NM Stat § 59A-22-41.1 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-41.1 - Coverage for medical diets for genetic inborn errors of metabolism.

A. As of July 1, 2003, each individual and group health insurance policy, health care plan, certificate of health insurance and managed health care plan delivered, issued for delivery, renewed, extended or modified in this state shall provide coverage for the treatment of genetic inborn errors of metabolism that involve amino acid, carbohydrate and fat metabolism and for which medically standard methods of diagnosis, treatment and monitoring exist.B. Coverage shall include expenses of diagnosing, monitoring and controlling disorders by nutritional and medical assessment, including clinical services, biochemical analysis, medical supplies, prescription drugs, corrective lenses for conditions related to the genetic inborn error of metabolism, nutritional management and special medical foods used in treatment to compensate for the metabolic abnormality and to maintain adequate nutritional status. C. Services required to be covered pursuant to this section are subject to the terms and conditions of the applicable individual or group policy or plan that establishes durational limits, dollar limits, deductibles and co-payments as long as the terms are not less favorable than for physical illness generally.D. As used in this section:(1) "genetic inborn error of metabolism" means a rare, inherited disorder that:(a) is present at birth;(b) if untreated, results in intellectual or developmental disability or death; and (c) causes the necessity for consumption of special medical foods;(2) "special medical foods" means nutritional substances in any form that are:(a) formulated to be consumed or administered internally under the supervision of a physician;(b) specifically processed or formulated to be distinct in one or more nutrients present in natural food;(c) intended for the medical and nutritional management of patients with limited capacity to metabolize ordinary foodstuffs or certain nutrients contained in ordinary foodstuffs or who have other specific nutrient requirements as established by medical evaluation; and(d) essential to optimize growth, health and metabolic homeostasis; and(3) "treatment" means medical services provided by licensed health care professionals, including physicians, dieticians and nutritionists, with specific training in managing patients diagnosed with genetic inborn errors of metabolism. History: Laws 2003, ch. 192, § 1; 2021, ch. 108, § 20. ANNOTATIONSThe 2021 amendment, effective July 1, 2021, revised a term used in the section; in Subsection D, in Subparagraph D(1)(b), after "results in", deleted "mental retardation" and added "intellectual or developmental disability".
NM Stat § 59A-22-44 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-44 - Coverage for smoking cessation treatment.

A. An individual or group health insurance policy, health care plan or certificate of health insurance that is delivered or issued for delivery in this state and that offers maternity benefits shall offer coverage for smoking cessation treatment. B. Coverage for smoking cessation treatment may be subject to deductibles and coinsurance consistent with those imposed on other benefits under the same policy, plan or certificate. C. The provisions of this section shall not apply to short-term travel, accident-only or limited or specified-disease policies. History: Laws 2003, ch. 337, § 1. ANNOTATIONSEffective dates. — Laws 2003, ch. 337 contained no effective date provision, but, pursuant to N.M. Const., art. IV, § 23, was effective June 20, 2003, 90 days after adjournment of the legislature. Applicability. — Laws 2003, ch. 337 § 7 made the provisions of the act apply on or after July 1, 2003.
NM Stat § 59A-22-45 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-45 - Coverage of alpha-fetoprotein IV screening test.

An individual or group health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in the state shall provide coverage for an alpha-fetoprotein IV screening test for pregnant women, generally between sixteen and twenty weeks of pregnancy, to screen for certain genetic abnormalities in the fetus. History: Laws 2004, ch. 122, § 3. ANNOTATIONSEffective dates. — Laws 2004, ch. 122, § 13 made the act effective July 1, 2004.
NM Stat § 59A-22-46 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-46 - Coverage of part-time employees.

An insurer that provides group health insurance pursuant to Chapter 59A, Article 22 NMSA 1978 shall make available, upon an employer's request prior to issuance, delivery or renewal, coverage for regular part-time employees who work or are expected to work an average of at least twenty hours per week over a six-month period. Nothing in this section shall be construed to require an employer to offer or provide coverage for regular part-time employees. History: Laws 2005, ch. 42, § 1. ANNOTATIONSEffective dates. — Laws 2005, ch. 42, § 5 made Laws 2005, ch. 42, § 1 effective July 1, 2005.
NM Stat § 59A-22-47 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-47 - Coverage of colorectal cancer screening.

A. An individual or group health insurance policy, health care plan and certificate of health insurance that is delivered, issued for delivery or renewed in this state shall provide coverage for colorectal screening for determining the presence of precancerous or cancerous conditions and other health problems. The coverage shall make available colorectal cancer screening, as determined by the health care provider in accordance with the evidence-based recommendations established by the United States preventive services task force. B. Coverage for colorectal screening may be subject to deductibles and coinsurance consistent with those imposed on other benefits under the same policy, plan or certificate. C. The provisions of this section shall not apply to short-term travel, accident-only or limited or specified-disease policies. History: Laws 2007, ch. 17, § 1. ANNOTATIONSEffective dates. — Laws 2007, ch. 17, contained no effective date provision, but, pursuant to N.M. Const., art. IV, § 23, was effective June 15, 2007, 90 days after the adjournment of the legislature.
NM Stat § 59A-22-48 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-48 - General anesthesia and hospitalization for dental surgery.

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 provide coverage for hospitalization and general anesthesia provided in a hospital or ambulatory surgical center for dental surgery for the following: (1) insureds exhibiting physical, intellectual or medically compromising conditions for which dental treatment under local anesthesia, with or without additional adjunctive techniques and modalities, cannot be expected to provide a successful result and for which dental treatment under general anesthesia can be expected to produce superior results; (2) insureds for whom local anesthesia is ineffective because of acute infection, anatomic variation or allergy; (3) insured children or adolescents who are extremely uncooperative, fearful, anxious or uncommunicative with dental needs of such magnitude that treatment should not be postponed or deferred and for whom lack of treatment can be expected to result in dental or oral pain or infection, loss of teeth or other increased oral or dental morbidity; (4) insureds with extensive oral-facial or dental trauma for which treatment under local anesthesia would be ineffective or compromised; or (5) other procedures for which hospitalization or general anesthesia in a hospital or ambulatory surgical center is medically necessary. B. The provisions of this section do not apply to short-term travel, accident-only or limited or specified disease policies. C. Coverage for dental surgery may be subject to copayments, deductibles and coinsurance subject to network and prior authorization requirements consistent with those imposed on other benefits under the same policy, plan or certificate. History: Laws 2007, ch. 218, § 2. ANNOTATIONSEffective dates. — Laws 2007, ch. 218, § 6 made Laws 2007, ch. 218, § 2 effective July 1, 2007.
NM Stat § 59A-22-49.1 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-49.1 - Coverage for orally administered anticancer medications; limits on patient costs.

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 and that provides coverage for cancer treatment shall provide coverage for a prescribed, orally administered anticancer medication that is used to kill or slow the growth of cancerous cells on a basis no less favorable than intravenously administered or injected cancer medications that are covered as medical benefits by the plan. B. An insurer shall not increase patient cost-sharing for anticancer medications in order to achieve compliance with the provisions of this section. C. Coverage of orally administered anticancer medication shall not be subject to any prior authorization, dollar limit, copayment, deductible or coinsurance provision that does not apply to intravenously administered or injected anticancer medication used to kill or slow the growth of cancerous cells. D. As used in this section, "insurer" or "health plan": (1) means: (a) a health insurer; (b) a nonprofit health service provider; (c) a health maintenance organization; (d) a managed care organization; or (e) a provider service organization; and (2) does not include individual policies intended to supplement major medical group-type coverages such as medicare supplement, long-term care, disability income, specified disease, accident-only, hospital indemnity or other limited-benefit health insurance policies. History: Laws 2011, ch. 55, § 2. ANNOTATIONSEffective dates. — Laws 2011, ch. 55, § 7 made Laws 2011, ch. 55, § 2 effective June 17, 2011. Applicability. — Laws 2011, ch. 55, § 6 provided that the provisions of this act apply to insurance policies that provide coverage for cancer treatment and that are delivered, issued for delivery, amended, renewed or continued in this state on or after January 1, 2012.
NM Stat § 59A-22-49.2 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-49.2 - Coverage of prescription eye drop refills.

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 and that provides coverage for prescription eye drops shall not deny coverage for a renewal of prescription eye drops when: (1) the renewal is requested by the insured at least twenty-three days for a thirty-day supply of eye drops, forty-five days for a sixty-day supply of eye drops or sixty-eight days for a ninety-day supply of eye drops from the later of the date that the original prescription was dispensed to the insured or the date that the last renewal of the prescription was dispensed to the insured; and (2) the prescriber indicates on the original prescription that additional quantities are needed and that the renewal requested by the insured does not exceed the number of additional quantities needed. B. As used in this section, "prescriber" means a person who is authorized pursuant to the New Mexico Drug, Device and Cosmetic Act [Chapter 26, Article 1 NMSA 1978] to prescribe prescription eye drops. History: Laws 2012, ch. 27, § 2. ANNOTATIONSEffective dates. — Laws 2012, ch. 27, § 7 made Laws 2012, ch. 27, § 2 effective January 1, 2013. Applicability. — Laws 2012, ch. 27, § 6 provided that the provisions of Laws 2012, ch. 27, §§ 1 to 5 apply to insurance policies that provide coverage for prescription eye drops and that are delivered, issued for delivery, amended, renewed or continued in this state on or after January 1, 2013.
NM Stat § 59A-22-51 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-51 - Dental insurance plan; dental fees not covered; severability.

A. As used in this section: (1) "covered services" means dental care services for which a reimbursement is available under an enrollee's plan contract or for which a reimbursement would be available but for the application of contractual limitations such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums, frequency limitations, alternative benefit payments or any other limitation; and (2) "dental insurance plan" means any policy of insurance that is issued by a health care service contractor that provides for coverage of dental services not in connection with a medical plan. B. No contract of any health care service contractor that covers any dental services and no contract or participating provider agreement with a dentist shall require, directly or indirectly, that a dentist who is a participating provider provide services to an enrolled participant at a fee set by, or at a fee subject to the approval of, the health care service contractor unless the dental services are covered services. C. A health care service contractor or other person providing third party administrator services shall not make available any providers in its dentist network to a plan that sets dental fees for any services except covered services. D. If any part or application of this section is held invalid, the remainder or its application to other situations or persons shall not be affected. History: Laws 2011, ch. 128, § 1. ANNOTATIONSEmergency clauses. — Laws 2011, ch. 128, § 2 contained an emergency clause and was approved April 7, 2011.
NM Stat § 59A-22-52 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-52 - Prescription drug prior authorization protocols.

A. After January 1, 2014, a health insurer shall accept the uniform prior authorization form developed pursuant to Sections 2 [59A-2-9.8 NMSA 1978] and 3 [61-11-6.2 NMSA 1978] of this 2013 act as sufficient to request prior authorization for prescription drug benefits. B. No later than twenty-four months after the adoption of national standards for electronic prior authorization, a health insurer shall exchange prior authorization requests with providers who have e-prescribing capability. C. If a health insurer fails to use or accept the uniform prior authorization form or fails to respond within three business days upon receipt of a uniform prior authorization form, the prior authorization request shall be deemed to have been granted. D. As used in this section, "health insurer": (1) means: (a) a health insurer; (b) a nonprofit health service provider; (c) a health maintenance organization; (d) a managed care organization; or (e) a provider service organization; and (2) does not include: (a) a person that delivers, issues for delivery or renews an individual policy intended to supplement major medical group-type coverages such as medicare supplement, long-term care, disability income, specified disease, accident-only, hospital indemnity or other limited-benefit health insurance policy; (b) a physician or a physician group to which a health insurer has delegated financial risk for prescription drugs and that does not use a prior authorization process for prescription drugs; or (c) a health insurer or its affiliated providers if the health insurer owns and operates its pharmacies and does not use a prior authorization process for prescription drugs. History: Laws 2013, ch. 170 , § 5. ANNOTATIONSEffective dates. — Laws 2013, ch. 170 contained no effective date provision, but, pursuant to N.M. Const., art. IV, § 23, was effective June 14, 2013, 90 days after the adjournment of the legislature.