New Mexico Regulations
Parity Report
This page lists some of the action toward parity compliance undertaken by state regulatory agencies since 2008.
Are we missing any actions taken by state regulatory agencies? Let us know at info@paritytrack.org
Action in the Regulatory Arena
05/2018
Primary Focus | Mandated Benefit; Provider; Parity |
Title/Description | General Program Description for Managed Care Organizations |
Agency | New Mexico Human Services Department |
Citation | N.M. Code R. § 8.308.9.11(E) |
Summary | Managed Care Organizations shall meet all behavioral health parity requirements as set forth in CFR 42, Chapter IV, subchapter C, 438.905 – Parity requirements. |
Effective Date | 5/1/2018 |
Notes | 8.308.9.11 NMAC – Rp, 8.308.9.11 NMAC, 5/1/2018 |
Primary Focus | Mandated Benefit; Provider |
Title/Description | Behavioral Health Services for Managed Care Organizations |
Agency | New Mexico Human Services Department |
Citation | N.M. Code R. § 8.308.9.19 |
Summary | MCOs must cover the enumerated behavioral health services. Some services include applied behavior analysis, crises services, and comprehensive community support services. |
Effective Date | 5/1/2018 |
Notes | 8.308.9.19 NMAC – Rp, 8.308.9.19 NMAC, 5/1/2018 |
03/2015
New Mexico’s Office of the Superintendent of Insurance (OSI) issued a bulletin (pdf | Get Adobe® Reader®) to insurance plans about autism coverage. The bulletin explained that because of the Affordable Care Act (ACA), individual plans and small employer fully-insured plans are not allowed to impose the annual maximums ($36,000) and lifetime maximums ($200,000) for autism care that are specified in the section about autism coverage in the state insurance law (summarized at the bottom of this page).
The bulletin goes on to explain that although this part of the ACA does not apply to large employer fully-insured plans, the Federal Parity Law does, which means the annual maximums and lifetime maximums in the state law cannot be used for autism services if they are not used for other medical services.
The bulletin also asks the Legislature to change the section about autism coverage in the state insurance law so that it references the DSM V, not the DSM IV.
09/2014
New Mexico’s OSI issued a bulletin, (pdf | Get Adobe® Reader®) but withdrew it three days later. There were two sentences in the bulletin about the Federal Parity Law. It stated that plans have to cover behavioral health services “at parity with other medical conditions” if those services are offered.
National Parity Map
View the state parity reports to learn about legislation, regulation, and litigation related to parity implementation
National Parity MapGet Support
- New Mexico Insurance Division
- http://www.osi.state.nm.us/ManagedHealthCare/index.aspx
- 1-855-427-5674
Common Violations
In seeking care or services, be aware of the common ways parity rights can be violated.