reglab/housing_qa huggingface dataset:
NM Stat § 59A-46-38 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-38 - Newly born children coverage.

A. All individual and group health maintenance organization contracts delivered or issued for delivery in this state shall also provide that the health benefits applicable for children shall be payable with respect to a newly born child of the subscriber or the subscriber's spouse from the moment of birth. B. All individual and group health maintenance organization contracts delivered or issued for delivery in this state that do not provide health benefits applicable for children shall provide for an option to add to the coverage any newly born child of the insured provided that the requirements of Subsection D of this section have been met. C. The coverage for newly born children shall consist of coverage of injury or sickness, including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities and, where necessary to protect the life of the infant, transportation, including air transport, to the nearest available tertiary care facility for newly born infants. D. If a specific payment is required to provide coverage for a child, the contract may require that a notification of birth of a newly born child and payment must be furnished to the health maintenance organization within thirty-one days after the date of birth in order to have the coverage from birth. E. As used in this section and in Section 59A-46-28 NMSA 1978 [59A-46-39 NMSA 1978], "tertiary care facility" means a hospital unit which provides complete perinatal care and intensive care of intrapartum and perinatal high-risk patients with responsibilities for coordination of transport, communication, education and data analysis systems for the geographic area served. History: Laws 1984, ch. 127, § 874; 1993, ch. 169, § 2; 1978 Comp., § 59A-46-27, recompiled as § 59A-46-38 by Laws 1993, ch. 266, § 31. ANNOTATIONSThe 1993 amendment, effective June 18, 1993, added Subsection B; redesignated former Subsections B through D as Subsections C through E; substituted "from birth" for "continue beyond such thirty-one day period" in Subsection D; and substituted "Section 59A-46-28 NMSA 1978" for "Section 875 of this article" in Subsection E. Applicability. — Laws 1993, ch. 169, § 3 provided that the provisions of the act apply to policies, plans, contracts and certificates delivered or issued for delivery or renewed, extended or amended in the state on or after July 1, 1993.
NM Stat § 59A-46-38.2 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-38.2 - Childhood immunization coverage required.

A. Each individual and group health maintenance contract delivered or issued for delivery in this state shall provide coverage for childhood immunizations, in accordance with the current schedule of immunizations recommended by the American academy of pediatrics, including coverage for all medically necessary booster doses of all immunizing agents used in childhood immunizations. B. Coverage for childhood immunizations and necessary booster doses may be subject to deductibles and coinsurance consistent with those imposed on other benefits under the same contract. History: 1978 Comp., § 59A-46-38.2, enacted by Laws 1997, ch. 250, § 4.
NM Stat § 59A-46-38.3 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-38.3 - Maximum age of dependent.

Each individual or group health maintenance organization contract delivered or issued for delivery or renewed in New Mexico that provides coverage for an enrollee's dependents shall not terminate coverage of an unmarried dependent by reason of the dependent's age before the dependent's twenty-sixth birthday, regardless of whether the dependent is enrolled in an educational institution; provided that this requirement does not apply to the medicaid managed care system. History: Laws 2003, ch. 391, § 5; 2005, ch. 41, § 2; 2021, ch. 108, § 27. ANNOTATIONSCross references. — For age of dependents, see 59A-22-2 and 59A-22-34.2 NMSA 1978. The 2021 amendment, effective July 1, 2021, after "before the dependent's", changed "twenty-fifth" to "twenty-sixth". The 2005 amendment, effective July 1, 2005, provides that individual and group health maintenance organization contracts delivered or renewed in New Mexico that provide coverage for an enrollee's dependents shall not terminate coverage of unmarried dependents by reason of age before the twenty-fifth birthday.
NM Stat § 59A-46-38.4 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-38.4 - Coverage of circumcision for newborn males.

An individual or group health maintenance organization policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in the state shall provide coverage for circumcision for newborn males. History: Laws 2004, ch. 122, § 8. ANNOTATIONSEffective dates. — Laws 2004, ch. 122, § 13 made Laws 2004, ch. 122, § 8 effective July 1, 2004.
NM Stat § 59A-46-38.5 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-38.5 - Hearing aid coverage for children required.

A. An individual or group health maintenance organization contract delivered, issued for delivery or renewed in this state shall provide coverage for a hearing aid and any related service for the full cost of one hearing aid per hearing-impaired ear up to two thousand two hundred dollars ($2,200) every thirty-six months for hearing aids for insured children under eighteen years of age or under twenty-one years of age if still attending high school. The insured may choose a higher priced hearing aid and may pay the difference in cost above the two-thousand-two-hundred-dollar ($2,200) limit as provided in this subsection without financial or contractual penalty to the insured or to the provider of the hearing aid. B. An insurer that delivers, issues for delivery or renews in this state an individual or group health maintenance organization contract may make available to the policyholder the option of purchasing additional hearing aid coverage that exceeds the services described in this section. C. Hearing aid coverage offered shall include fitting and dispensing services, including providing ear molds as necessary to maintain optimal fit, provided by an audiologist, a hearing aid dispenser or a physician, licensed in New Mexico. A health maintenance organization has the discretion to determine the provider of hearing aids with which it contracts. Nothing in this section shall be construed to preclude a health maintenance organization from conducting medical necessity or utilization review for hearing aids and related services. D. The provisions of this section do not apply to short-term travel, accident-only or limited or specified disease policies. E. Coverage for hearing aids may be subject to deductibles and coinsurance consistent with those imposed on other benefits under the same policy, plan or certificate. F. For the purposes of this section, "hearing aid" means durable medical equipment that is of a design and circuitry to optimize audibility and listening skills in the environment commonly experienced by children. History: Laws 2007, ch. 356, § 4. ANNOTATIONSEffective dates. — Laws 2007, ch. 356, § 6 made this section effective July 1, 2007.
NM Stat § 59A-46-39 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-39 - Maternity transport required.

All individual and group health maintenance organization contracts delivered or issued for delivery in this state which provide maternity coverage shall also provide, where necessary to protect the life of the infant or mother, coverage for transportation, including air transport, for the medically high-risk pregnant woman with an impending delivery of a potentially viable infant to the nearest available tertiary care facility as defined in Section 874 [59A-46-38 NMSA 1978] of this article for newly born infants. History: Laws 1984, ch. 127, § 875; 1978 Comp., § 59A-46-28, recompiled as § 59A-46-39 by Laws 1993, ch. 266, § 31.
NM Stat § 59A-46-40 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-40 - Home health care service option required.

A. Each health maintenance organization which delivers or issues for delivery in this state an individual or group contract shall make available to the contract holder the option of home health care coverage which includes benefits for the services described in this section. B. Home health care coverage offered shall include: (1) services provided by a registered nurse or a licensed practical nurse; (2) health services provided by physical, occupational and respiratory therapists and speech pathologists; and (3) health services provided by a home health aide. C. Home health care coverage may be limited to: (1) services provided on the written order of a licensed physician, provided such order is renewed at least every sixty days; (2) services provided, directly or through contractual agreements, by a home health agency licensed in the state in which the home health services are delivered; and (3) services, as set forth in Subsection B of this section, without which the insured would have to be hospitalized. D. Coverage shall be provided for at least one hundred home visits per enrollee per year, with each home visit including up to four hours of home health care services. E. For the purposes of this section, "home health care" means health services provided on a part-time, intermittent basis to an individual confined to his home due to physical illness. History: Laws 1984, ch. 127, § 876; 1978 Comp., § 59A-46-29, recompiled as § 59A-46-40 by Laws 1993, ch. 266, § 31.
NM Stat § 59A-46-41 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-41 - Coverage for mammograms.

A. Each individual and group health maintenance organization contract 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 contract. History: Laws 1990, ch. 5, § 1; 1978 Comp., § 59A-46-35, recompiled as § 59A-46-41 by Laws 1993, ch. 266, § 31. 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-46-41.1 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-41.1 - Mastectomies and lymph node dissection; minimum hospital stay coverage required.

A. Each individual and group health maintenance contract 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. 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 contract. History: 1978 Comp., § 59A-46-41.1, enacted by Laws 1997, ch. 249, § 4.
NM Stat § 59A-46-41.2 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-41.2 - Prior authorization for gynecological or obstetrical ultrasounds prohibited.

A. An individual or group health maintenance organization contract 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 maintenance organization 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, § 5.ANNOTATIONSEmergency clauses. — Laws 2019, ch. 182, § 7 contained an emergency clause and was approved April 3, 2019.
NM Stat § 59A-46-42 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-42 - Coverage for cytologic and human papillomavirus screening.

A. Each individual and group health maintenance organization contract delivered or issued for delivery in this state shall provide coverage for cytologic and human papillomavirus screening to determine 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 contract. C. For the purposes of this section: (1) "cytologic screening" means a Papanicolaou test and 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: Laws 1992, ch. 56, § 1; 1978 Comp., § 59A-46-36, recompiled by § 59A-46-42 by Laws 1993, ch. 266, § 31; 2005, ch. 133, § 1. ANNOTATIONSThe 2005 amendment, effective June 17, 2005, provided in Subsection A that each health maintenance organization contract shall 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 C, defined "health care provider" to include any person who performs human papillomavirus screening and "human papillomavirus screening" to mean a text for detection of human papillomavirus.
NM Stat § 59A-46-42.1 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-42.1 - Coverage for the human papillomavirus vaccine.

A. An individual or group health maintenance organization contract 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, § 3; 2021, ch. 108, § 28. 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-46-43.2 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-43.2 - Coverage for medical diets for genetic inborn errors of metabolism.

As of July 1, 2003, each health maintenance organization that delivers or issues for delivery in the state an individual or group contract shall provide coverage for the treatment of genetic inborn errors of metabolism as set forth in Chapter 59A, Article 22 NMSA 1978. History: Laws 2003, ch. 192, § 2. ANNOTATIONSEffective dates. — Laws 2003, ch. 192 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.
NM Stat § 59A-46-45 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-45 - Coverage for smoking cessation treatment.

A. An individual or group health maintenance organization contract 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 contract. History: Laws 2003, ch. 337, § 4. 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, effective June 20, 2003, made the provisions of Laws 2003, ch. 337 § 4 applicable on or after July 1, 2003.
NM Stat § 59A-46-46 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-46 - Coverage of alpha-fetoprotein IV screening test.

An individual or group health maintenance organization 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, § 7. ANNOTATIONSEffective dates. — Laws 2004, ch. 122, § 13 made Laws 2004, ch. 122, § 7 effective July 1, 2004.
NM Stat § 59A-46-47 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-47 - Coverage of part-time employees.

A health maintenance organization that provides coverage for health care services pursuant to the Health Maintenance Organization Law 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, § 3. ANNOTATIONSEffective dates. — Laws 2005, ch. 42, § 5 made Laws 2005, ch. 42, § 3 effective July 1, 2005.
NM Stat § 59A-46-48 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-48 - Coverage of colorectal cancer screening.

A. An individual or group health maintenance organization contract 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. History: Laws 2007, ch. 17, § 3. 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-46-49 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 46 - Health Maintenance Organizations|Section 59A-46-49 - General anesthesia and hospitalization for dental surgery.

A. An individual or group health maintenance organization contract 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, § 4. ANNOTATIONSEffective dates. — Laws 2007, ch. 218, § 6 made Laws 2007, ch. 218, § 4 effective July 1, 2007.