reglab/housing_qa huggingface dataset:
NM Stat § 59A-47-28 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 47 - Nonprofit Health Care Plans|Section 59A-47-28 - Coverage for service of chiropractor.

All individual and group subscriber contracts delivered or issued for delivery in New Mexico, which, on a service basis or on an indemnity basis, or both, provide for treatment of persons for the prevention, cure or correction of any illness or physical or mental condition shall include coverage for the services of a chiropractor. History: Laws 1984, ch. 127, § 879.26. ANNOTATIONSCompiler's notes. — Laws 1984, ch. 127, § 879.27, read "The provisions of this section shall be repealed effective July 1, 1987." However, Laws 1984, ch. 127, § 879.27, contained no provisions other than those quoted above and as such has not been codified.
NM Stat § 59A-47-28.1 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 47 - Nonprofit Health Care Plans|Section 59A-47-28.1 - Coverage for service of certified nurse-midwives and registered lay midwives.

A. Any individual and group subscriber contracts delivered in New Mexico which provide for obstetrical and/or maternity benefits on a service basis or an indemnity basis, or both, provide for treatment of persons for the prevention, cure or correction of any illness or physical or mental condition shall include coverage for the services of a certified nurse-midwife or registered lay midwife as defined in Subsection B of this section. Deductibles, limits of coverage or other terms and conditions of coverage for such services shall not differ substantially from coverage for the same or similar services provided by other practitioners. B. As used in this section: (1) "certified nurse-midwife" means any person who is licensed by the board of nursing as a registered nurse and who is registered with the health services division of the health and environment department [department of health] as a certified nurse-midwife; and (2) "registered lay midwife" means any person who practices lay midwifery and who is registered as a registered lay midwife by the health services division of the health and environment department [department of health]. History: 1978 Comp., § 59A-47-28.1, enacted by Laws 1985, ch. 192, § 2. ANNOTATIONSCross references. — For freedom of choice of hospital and practitioner, see 59A-22-32 NMSA 1978. Bracketed material. — The bracketed material was inserted by the compiler and it is not part of the law. Laws 1991, ch. 25, § 16 repealed former 9-7-4 NMSA 1978, relating to the health and environment department, and enacted a new 9-7-4 NMSA 1978, creating the department of health. Applicability. — Laws 1985, ch. 192, § 3 made the provisions of Laws 1985, ch. 192, § 2 applicable to any policy or contract which was delivered or issued for delivery in this state on or after July 1, 1985, and to any existing policy, contract or plan on its anniversary or renewal date after June 30, 1985, or at the expiration of the applicable collective bargaining contract, if any, whichever is later.
NM Stat § 59A-47-28.2 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 47 - Nonprofit Health Care Plans|Section 59A-47-28.2 - Doctor of oriental medicine discrimination prohibited.

All individual and group subscriber contracts delivered or issued for delivery in New Mexico by a nonprofit health care plan that, on a service or indemnity basis, or both, provide for treatment of persons for the prevention, cure or correction of any illness or physical or mental condition shall not contain any provisions that exclude a licensed doctor of oriental medicine as a provider of oriental medical services and shall not discriminate in the reimbursement levels for such services between types of licensed health care providers. History: 1978 Comp., § 59A-47-28.2, enacted by Laws 1991, ch. 145, § 1; 1993, ch. 158, § 6. ANNOTATIONSCross references. — For prohibition against discrimination against acupuncture practitioner, see 59A-46-36 NMSA 1978. For Acupuncture Practice Act, see Chapter 61, Article 14A NMSA 1978. The 1993 amendment, effective June 18, 1993, substituted "Doctor of Oriental Medicine" for "Oriental Medical Doctor" in the section heading and substituted "licensed doctor of oriental medicine" for "licensed oriental medical doctor" near the end of the section.
NM Stat § 59A-47-28.3 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 47 - Nonprofit Health Care Plans|Section 59A-47-28.3 - Provider discrimination prohibited.

All individual and group subscriber contracts delivered or issued for delivery in New Mexico that, on a prepaid, service or indemnity basis, or all of them, provide for treatment of persons for the prevention, cure or correction of an illness or physical or mental condition shall include coverage for the services of a physician assistant and a certified nurse practitioner. Deductibles, limits of coverage or other terms and conditions of coverage for certified nurse practitioners and physician assistants shall not differ substantially from coverage for the same or similar services provided by other practitioners. Nothing in this section shall restrict a health care plan from including in the terms of its coverage any benefit differences based on differences in the scope of practice of health care practitioners. History: 1978 Comp., § 59A-47-28.3, enacted by Laws 1998, ch. 39, § 2; 2008, ch. 9, § 6. ANNOTATIONSThe 2008 amendment, effective May 14, 2008, added "physician assistant".
NM Stat § 59A-47-28.4 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 47 - Nonprofit Health Care Plans|Section 59A-47-28.4 - Coverage for collaborative practice; dental therapists; dental hygienists.

An individual or group subscriber contract delivered or issued for delivery in New Mexico that, on a prepaid, service or indemnity basis, provides for treatment of persons for the prevention, cure or correction of any illness or physical or mental condition shall include coverage for the services of a dental therapist and a dental hygienist in a collaborative practice pursuant to the Dental Health Care Act [Chapter 61, Article 5A NMSA 1978]. History: Laws 2003, ch. 343, § 4; 2019, ch. 107, § 16. ANNOTATIONSThe 2019 amendment, effective June 14, 2019, required subscriber contracts of a health plan to include the services of dental therapists; in the section heading, added "dental therapists", and after "coverage for the services of a", added "dental therapist".
NM Stat § 59A-47-29 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 47 - Nonprofit Health Care Plans|Section 59A-47-29 - Settlement of disputes; appeal.

The parties to a dispute between a health care plan and a purveyor arising out of a health care expense payments contract may submit the dispute to the superintendent for his final decision and his final decision shall then be binding upon the parties to the contract. A party to the contract may seek review of the superintendent's decision by filing an appeal in the district court pursuant to the provisions of Section 39-3-1.1 NMSA 1978. History: Laws 1984, ch. 127, § 879.28; 1998, ch. 55, § 68; 1999, ch. 265, § 71. ANNOTATIONSThe 1999 amendment, effective July 1, 1999, substituted "Section 39-3-1.1" for "Section 12-8A-1" in the last sentence. The 1998 amendment, effective September 1, 1998, rewrote this section to the extent that a detailed comparison is impracticable.
NM Stat § 59A-47-31 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 47 - Nonprofit Health Care Plans|Section 59A-47-31 - Rehabilitation, liquidation or dissolution.

If the superintendent finds that expenses incurred by a health care plan for acquisition of business or administration exceed the limits prescribed under Section 879.17 [59A-47-19 NMSA 1978] of this article, or that the health care plan is at any time unable or prospectively unable to fulfill its outstanding contracts and also to meet the requirements of this article as to expenses, reserves, deposit and surplus funds, or is otherwise insolvent or likely to become insolvent, the superintendent may institute and maintain proceedings to conserve, rehabilitate, liquidate or dissolve such health care plan pursuant to the provisions of Article 41 [Chapter 59A, Article 41 NMSA 1978] (conservation, rehabilitation, liquidation) of the Insurance Code as applicable to insurers. History: Laws 1984, ch. 127, § 879.30.
NM Stat § 59A-47-32 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 47 - Nonprofit Health Care Plans|Section 59A-47-32 - Unauthorized contract or adjustment transactions; penalty.

A. Any person writing or attempting to write, solicit or procure health care plan contracts within this state without a certificate of authority or license duly issued in accordance with the Insurance Code and then required and subsisting, and any person adjusting, settling or knowingly accepting adjustment or settlement of any loss covered by a contract written or issued by any health care plan not holding a subsisting certificate of authority issued by the superintendent, shall be guilty of a misdemeanor, and upon conviction thereof shall be fined not less than one hundred dollars ($100) nor more than one thousand dollars ($1,000), or imprisoned in the county jail for not less than thirty (30) nor more than sixty (60) days, or both such fine and imprisonment in the court's discretion. B. The exemptions from certificate of authority requirements of insurers as provided in Section 78 [59A-5-11 NMSA 1978] of the Insurance Code shall to the extent applicable also apply as to health care plans and their contracts under this section. History: Laws 1984, ch. 127, § 879.31. ANNOTATIONSCross references. — For the Insurance Code, see 59A-1-1 NMSA 1978 and notes thereto.
NM Stat § 59A-47-36 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 47 - Nonprofit Health Care Plans|Section 59A-47-36 - Nonprofit health care plans; contract or certificate provisions relating to individuals who are eligible for medical benefits under the medicaid program.

A. Each individual or group contract for health care expense payments or certificate therefor that is delivered, issued for delivery or renewed in this state by a health care plan shall include provisions that require benefits paid on behalf of a subscriber under the contract or certificate to be paid to the human services department when: (1) the human services department has paid or is paying health care expenses on behalf of the subscriber under the state's medicaid program pursuant to Title XIX of the federal Social Security Act, 42 U.S.C. 1396, et seq.; (2) payment for the expenses in question has been made by the human services department to the medicaid provider; and (3) the health care plan is notified that the subscriber receives benefits under the medicaid program and that benefits must be paid directly to the human services department. B. The notice required under Paragraph (3) of Subsection A of this section may be accomplished through an attachment to the claim by the human services department for health care expense payments when the claim is first submitted by the human services department to the health care plan. C. Notwithstanding any other provisions of law, checks in payment for claims pursuant to any individual or group contract for health care expense payments or certificate therefor for health care services provided to subscribers who are also eligible for benefits under the medicaid program and provided by medical providers qualified to participate under the contract or certificate shall be made payable to the provider. The health care plan may be notified that the subscriber is eligible for medicaid benefits through an attachment to the claim by the provider for health care expense payments when the claim is first submitted by the provider to the health care plan. D. No individual or group contract for health care expense payments or certificate therefor delivered, issued for delivery or renewed in this state on or after the effective date of this section shall contain any provision denying or limiting contract benefits because services are rendered to a subscriber who is eligible for or who has received medical assistance under the medicaid program of this state. E. To the extent that payment for covered expenses has been made pursuant to the state medicaid program for health care items or services furnished to an individual, in any case where a health care plan has a legal liability to make payments, the state is considered to have acquired the rights of the individual to payment by the health care plan for those health care items or services. History: 1978 Comp., § 59A-47-36, enacted by Laws 1989, ch. 183, § 7; 1994, ch. 64, § 11. ANNOTATIONSThe 1994 amendment, effective July 1, 1994, added Subsection E.
NM Stat § 59A-47-37.1 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 47 - Nonprofit Health Care Plans|Section 59A-47-37.1 - Hearing aid coverage for children required.

A. An individual or group health insurance policy, health care plan or certificate of health insurance delivered or issued for delivery 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 insurance policy, health care plan or certificate of health insurance 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. 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, § 5. ANNOTATIONSEffective dates. — Laws 2007, ch. 356, § 6 made Laws 2007, ch. 356, § 5 effective July 1, 2007.
NM Stat § 59A-47-38 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 47 - Nonprofit Health Care Plans|Section 59A-47-38 - Coverage for medical diets for genetic inborn errors of metabolism.

As of July 1, 2003, subscriber contracts of a health care plan shall also be subject to coverage for special medical diets for genetic inborn errors of metabolism as required of health insurers in Chapter 59A, Article 22 NMSA 1978. History: Laws 2003, ch. 192, § 3. 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-47-39 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 47 - Nonprofit Health Care Plans|Section 59A-47-39 - Employer utilization and loss experience availability.

Employer claims information, including utilization and loss experience under health insurance provided under Chapter 59A, Article 47 NMSA 1978 shall be made available by the carrier only upon the written request of and to employers of subscribers with such coverage within thirty days of an employer's written request to the carrier for such information, provided the employer's coverage extends to no less than twenty-five individual subscribers, 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, § 5; 2007, ch. 53, § 3. 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-47-40 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 47 - Nonprofit Health Care Plans|Section 59A-47-40 - Maximum age of dependent.

An individual or group health care coverage, including any form of self-insurance, offered, issued or renewed under the Health Care Purchasing Act that offers coverage of an insured's dependent 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. History: Laws 2003, ch. 391, § 7; 2005, ch. 41, § 3; 2021, ch. 108, § 30. 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, provided that an individual or group health care coverage under the Health Care Purchasing Act shall not terminate coverage of unmarried dependents by reason of age before the twenty-fifth birthday.
NM Stat § 59A-47-41 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 47 - Nonprofit Health Care Plans|Section 59A-47-41 - 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, § 9. ANNOTATIONSEffective dates. — Laws 2004, ch. 122, § 13 made Laws 2004, ch. 122, § 9 effective July 1, 2004.
NM Stat § 59A-47-41.1 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 47 - Nonprofit Health Care Plans|Section 59A-47-41.1 - Prior authorization for gynecological or obstetrical ultrasounds prohibited.

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 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: (1) "health care plan" means an organization that demonstrates to the office of superintendent of insurance that it has been granted exemption from the federal income tax by the United States commissioner of internal revenue as an organization described in Section 501(c)(3) of the United States Internal Revenue Code of 1986, as that section may be amended or renumbered, and is authorized by the office of superintendent of insurance to enter into contracts with subscribers and make health care expense payments; and (2) "prior authorization" means advance approval that is required by a health care plan 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, § 6. ANNOTATIONSCross references. — For Section 501(c)(3) of the Internal Revenue Code of 1986, see 26 U.S.C. § 501(c)(3).Emergency clauses. — Laws 2019, ch. 182, § 7 contained an emergency clause and was approved April 3, 2019.
NM Stat § 59A-47-42 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 47 - Nonprofit Health Care Plans|Section 59A-47-42 - Coverage of part-time employees.

A health care plan that provides coverage for health care pursuant to the Nonprofit Health Care Plan 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, § 4. ANNOTATIONSEffective dates. — Laws 2005, ch. 42, § 5 made Laws 2005, ch. 42, § 4 effective July 1, 2005.
NM Stat § 59A-47-43 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 47 - Nonprofit Health Care Plans|Section 59A-47-43 - Coverage of colorectal cancer screening.

A. An individual or group health policy, health care plan or 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, § 4. 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.