New Mexico § 13-7-27 - Diagnostic and supplemental breast examinations

§ 13-7-27. Diagnostic and supplemental breast examinations

A. Group health coverage, including self-insurance, offered, issued, amended, delivered

or renewed under the Health Care Purchasing Act that provides coverage for diagnostic

and supplemental breast examinations shall not impose cost sharing for diagnostic

and supplemental breast examinations. B. The provisions of this section do not apply to excepted benefit plans as provided

pursuant to the Short-Term Health Plan and Excepted Benefit Act, catastrophic plans

as defined pursuant to 42 USCA Section 18022(e) or high deductible health plans with health savings accounts until an eligible insured's

deductible has been met, unless otherwise allowed pursuant to federal law. C. As used in this section: (1) “ cost sharing ” means a deductible, coinsurance, copayment and any maximum limitation on the application

of such a deductible, coinsurance, copayment or similar out-of-pocket expense; (2) “ diagnostic breast examination ” means a medically necessary and clinically appropriate examination of the breast

using diagnostic mammography, breast magnetic resonance imaging or breast ultrasound

that evaluates an abnormality: (a) seen or suspected from a screening examination for breast cancer; or (b) detected by another means of examination; and (3) “ supplemental breast examination ” means a medically necessary and clinically appropriate examination of the breast

using breast magnetic resonance imaging or breast ultrasound that is: (a) used to screen for breast cancer when there is no abnormality seen or suspected;

and (b) based on personal or family medical history or additional factors that may increase

the individual's risk of breast cancer.