New Mexico § 13-7-26 - Behavioral health services; elimination of cost sharing

§ 13-7-26. Behavioral health services; elimination of cost sharing

A. Until January 1, 2027, group health coverage, including any form of self-insurance,

offered, issued or renewed under the Health Care Purchasing Act that offers coverage

of behavioral health services shall not impose cost sharing on those behavioral health

services. B. For the purposes of this section: (1) “ behavioral health services ” means professional and ancillary services for the treatment, habilitation, prevention

and identification of mental illnesses, substance abuse disorders and trauma spectrum

disorders, including inpatient, detoxification, residential treatment and partial

hospitalization, intensive outpatient therapy, outpatient and all medications, including

brand-name pharmacy drugs when generics are unavailable; (2) “ coinsurance ” means a cost-sharing method that requires an enrollee to pay a stated percentage

of medical expenses after any deductible amount is paid; provided that coinsurance

rates may differ for different types of services under the same group health plan; (3) “ copayment ” means a cost-sharing method that requires an enrollee to pay a fixed dollar amount

when health care services are received, with the plan administrator paying the balance

of the allowable amount; provided that there may be different copayment requirements

for different types of services under the same group health plan; and (4) “ cost sharing ” means a copayment, coinsurance, deductible or any other form of financial obligation

of an enrollee other than a premium or a share of a premium, or any combination of

any of these financial obligations, as defined by the terms of a group health plan.