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HOUSE BILL 527
57
TH LEGISLATURE
-
STATE
OF
NEW
MEXICO
-
FIRST SESSION
,
2025
INTRODUCED BY
Cristina Parajón
AN ACT
RELATING TO INSURANCE; ENACTING NEW SECTIONS OF THE HEALTH CARE
PURCHASING ACT, THE PUBLIC ASSISTANCE ACT AND THE NEW MEXICO
INSURANCE CODE TO REQUIRE COVERAGE FOR AN ADEQUATE SUPPLY OF
MEDICAL CANNABIS TO TREAT DEBILITATING CONDITIONS OF QUALIFIED
PATIENTS; PROVIDING FOR DIRECT PAYMENT TO CANNABIS RETAILERS OR
REIMBURSEMENT TO QUALIFIED PATIENTS.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
SECTION 1. A new section of the Health Care Purchasing
Act is enacted to read:
"[NEW MATERIAL] MEDICAL CANNABIS COVERAGE.--
A. As used in this section:
(1) "adequate supply" means an amount of
cannabis, in any form approved by the department of health,
possessed by a qualified patient that is determined by
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department of health rule to be no more than reasonably
necessary to ensure the uninterrupted availability of cannabis
for a period of three months and that is derived solely from an
intrastate source;
(2) "cannabis":
(a) means all parts of the plant
Cannabis containing a delta-9-tetrahydrocannabinol
concentration of more than three-tenths percent on a dry weight
basis, whether growing or not; the seeds of the plant; the
resin extracted from any part of the plant; and every compound,
manufacture, salt, derivative, mixture or preparation of the
plant, its seeds or its resin; and
(b) does not include the mature stalks
of the plant; fiber produced from the stalks; oil or cake made
from the seeds of the plant; any other compound, manufacture,
salt, derivative, mixture or preparation of the mature stalks,
fiber, oil or cake; the sterilized seed of the plant that is
incapable of germination; the weight of any other ingredient
combined with cannabis to prepare topical or oral
administrations, food, drink or another product; or hemp;
(3) "cannabis extract":
(a) means a product obtained by
separating resins from cannabis by solvent extraction using
solvents other than vegetable glycerin, such as butane, hexane,
isopropyl alcohol, ethanol or carbon dioxide; and
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(b) does not include the weight of any
other ingredient combined with cannabis extract to prepare
topical or oral administrations, food, drink or another
product;
(4) "cannabis product":
(a) means a product that contains
cannabis, including edible or topical products that may also
contain other ingredients; and
(b) does not include the weight of any
other ingredient combined with cannabis or cannabis extract to
prepare topical or oral administrations, food, drink or another
product;
(5) "cannabis retailer" means a person that
sells cannabis products to consumers, pursuant to a license
issued by the cannabis control division of the regulation and
licensing department pursuant to the Cannabis Regulation Act;
(6) "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 individual or group health maintenance
organization contract;
(7) "copayment" means a cost-sharing method
that requires an enrollee to pay a fixed dollar amount when
health care services are received, with the carrier paying the
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balance of the allowable amount; provided that there may be
different copayment requirements for different types of
services under the same individual or group health maintenance
organization contract;
(8) "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 an individual or group
health maintenance organization contract;
(9) "debilitating medical condition" means:
(a) cancer;
(b) glaucoma;
(c) multiple sclerosis;
(d) damage to the nervous tissue of the
spinal cord, with objective neurological indication of
intractable spasticity;
(e) seizure disorder, including
epilepsy;
(f) positive status for human
immunodeficiency virus or acquired immunodeficiency syndrome;
(g) admittance into hospice care in
accordance with rules promulgated by the department of health;
(h) amyotrophic lateral sclerosis;
(i) Crohn's disease;
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(j) hepatitis C infection;
(k) Huntington's disease;
(l) inclusion body myositis;
(m) inflammatory autoimmune-mediated
arthritis;
(n) intractable nausea or vomiting;
(o) obstructive sleep apnea;
(p) painful peripheral neuropathy;
(q) Parkinson's disease;
(r) posttraumatic stress disorder;
(s) severe chronic pain;
(t) severe anorexia or cachexia;
(u) spasmodic torticollis;
(v) ulcerative colitis; or
(w) any other medical condition, medical
treatment or disease as approved by the department of health;
(10) "generally accepted standards" means
standards of care and clinical practice, including guidelines
and recommendations from professional associations, that are
generally recognized by health care providers practicing in
relevant clinical specialties;
(11) "medical cannabis" means cannabis
products used by a qualified patient or in accordance with the
Lynn and Erin Compassionate Use Act; and
(12) "qualified patient" means a resident of
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New Mexico who holds a registry identification card pursuant to
the Lynn and Erin Compassionate Use Act.
B. Group health coverage, including a form of self-
insurance, offered, issued or renewed under the Health Care
Purchasing Act shall provide coverage for:
(1) medical cannabis that is consistent with
the coverage provided for medication that would otherwise be
prescribed in accordance with generally recognized standards to
treat the eligible insured's debilitating medical condition,
including cost-sharing requirements; and
(2) an adequate supply of medical cannabis;
provided that the eligible insured:
(a) is a qualified patient; and
(b) obtains cannabis from a cannabis
retailer approved by the insurer.
C. The insurer shall provide:
(1) reimbursement to an eligible insured after
the submission of a claim in accordance with the process
established by the insurer's plan and in compliance with
department of health rule; or
(2) direct payment to a cannabis retailer
authorized by the insurer after submission of the claim in
accordance with the process established by the insurer's plan
and in compliance with department of health rule."
SECTION 2. A new section of the Public Assistance Act is
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enacted to read:
"[NEW MATERIAL] COVERAGE OF MEDICAL CANNABIS.--
A. As used in this section:
(1) "adequate supply" means an amount of
cannabis, in any form approved by the department of health,
possessed by a qualified patient that is determined by
department of health rule to be no more than reasonably
necessary to ensure the uninterrupted availability of cannabis
for a period of three months and that is derived solely from an
intrastate source;
(2) "cannabis":
(a) means all parts of the plant
Cannabis containing a delta-9-tetrahydrocannabinol
concentration of more than three-tenths percent on a dry weight
basis, whether growing or not; the seeds of the plant; the
resin extracted from any part of the plant; and every compound,
manufacture, salt, derivative, mixture or preparation of the
plant, its seeds or its resin; and
(b) does not include the mature stalks
of the plant; fiber produced from the stalks; oil or cake made
from the seeds of the plant; any other compound, manufacture,
salt, derivative, mixture or preparation of the mature stalks,
fiber, oil or cake; the sterilized seed of the plant that is
incapable of germination; the weight of any other ingredient
combined with cannabis to prepare topical or oral
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administrations, food, drink or another product; or hemp;
(3) "cannabis extract":
(a) means a product obtained by
separating resins from cannabis by solvent extraction using
solvents other than vegetable glycerin, such as butane, hexane,
isopropyl alcohol, ethanol or carbon dioxide; and
(b) does not include the weight of any
other ingredient combined with cannabis extract to prepare
topical or oral administrations, food, drink or another
product;
(4) "cannabis product":
(a) means a product that contains
cannabis, including edible or topical products that may also
contain other ingredients; and
(b) does not include the weight of any
other ingredient combined with cannabis or cannabis extract to
prepare topical or oral administrations, food, drink or another
product;
(5) "cannabis retailer" means a person that
sells cannabis products to consumers, pursuant to a license
issued by the cannabis control division of the regulation and
licensing department pursuant to the Cannabis Regulation Act;
(6) "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
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coinsurance rates may differ for different types of services
under the same individual or group health maintenance
organization contract;
(7) "copayment" means a cost-sharing method
that requires an enrollee to pay a fixed dollar amount when
health care services are received, with the carrier paying the
balance of the allowable amount; provided that there may be
different copayment requirements for different types of
services under the same individual or group health maintenance
organization contract;
(8) "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 an individual or group
health maintenance organization contract;
(9) "debilitating medical condition" means:
(a) cancer;
(b) glaucoma;
(c) multiple sclerosis;
(d) damage to the nervous tissue of the
spinal cord, with objective neurological indication of
intractable spasticity;
(e) seizure disorder, including
epilepsy;
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(f) positive status for human
immunodeficiency virus or acquired immunodeficiency syndrome;
(g) admittance into hospice care in
accordance with rules promulgated by the department of health;
(h) amyotrophic lateral sclerosis;
(i) Crohn's disease;
(j) hepatitis C infection;
(k) Huntington's disease;
(l) inclusion body myositis;
(m) inflammatory autoimmune-mediated
arthritis;
(n) intractable nausea or vomiting;
(o) obstructive sleep apnea;
(p) painful peripheral neuropathy;
(q) Parkinson's disease;
(r) posttraumatic stress disorder;
(s) severe chronic pain;
(t) severe anorexia or cachexia;
(u) spasmodic torticollis;
(v) ulcerative colitis; or
(w) any other medical condition, medical
treatment or disease as approved by the department of health;
(10) "generally accepted standards" means
standards of care and clinical practice, including guidelines
and recommendations from professional associations, that are
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generally recognized by health care providers practicing in
relevant clinical specialties;
(11) "medical cannabis" means cannabis
products used by a qualified patient or in accordance with the
Lynn and Erin Compassionate Use Act; and
(12) "qualified patient" means a resident of
New Mexico who holds a registry identification card pursuant to
the Lynn and Erin Compassionate Use Act.
B. Medical assistance coverage provided pursuant to
the Public Assistance Act shall provide coverage for:
(1) medical cannabis that is consistent with
the coverage provided for medication that would otherwise be
prescribed in accordance with generally accepted standards to
treat the eligible enrollee's debilitating medical condition,
including cost-sharing requirements; and
(2) an adequate supply, as established by
department of health rule; provided that the eligible enrollee:
(a) is a qualified patient; and
(b) obtains cannabis from a cannabis
retailer approved by the insurer.
C. Medical assistance coverage provided pursuant to
the Public Assistance Act shall provide:
(1) reimbursement to an eligible enrollee
after the submission of a claim in accordance with the process
established by the department of health and in compliance with
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department rule; or
(2) direct payment to a cannabis retailer
authorized by the department of health after submission of the
claim in accordance with the process established by the
department of health and in compliance with department rule."
SECTION 3. A new section of Chapter 59A, Article 22 NMSA
1978 is enacted to read:
"[NEW MATERIAL] MEDICAL CANNABIS COVERAGE.--
A. As used in this section:
(1) "adequate supply" means an amount of
cannabis, in any form approved by the department of health,
possessed by a qualified patient that is determined by
department of health rule to be no more than reasonably
necessary to ensure the uninterrupted availability of cannabis
for a period of three months and that is derived solely from an
intrastate source;
(2) "cannabis":
(a) means all parts of the plant
Cannabis containing a delta-9-tetrahydrocannabinol
concentration of more than three-tenths percent on a dry weight
basis, whether growing or not; the seeds of the plant; the
resin extracted from any part of the plant; and every compound,
manufacture, salt, derivative, mixture or preparation of the
plant, its seeds or its resin; and
(b) does not include the mature stalks
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of the plant; fiber produced from the stalks; oil or cake made
from the seeds of the plant; any other compound, manufacture,
salt, derivative, mixture or preparation of the mature stalks,
fiber, oil or cake; the sterilized seed of the plant that is
incapable of germination; the weight of any other ingredient
combined with cannabis to prepare topical or oral
administrations, food, drink or another product; or hemp;
(3) "cannabis extract":
(a) means a product obtained by
separating resins from cannabis by solvent extraction using
solvents other than vegetable glycerin, such as butane, hexane,
isopropyl alcohol, ethanol or carbon dioxide; and
(b) does not include the weight of any
other ingredient combined with cannabis extract to prepare
topical or oral administrations, food, drink or another
product;
(4) "cannabis product":
(a) means a product that contains
cannabis, including edible or topical products that may also
contain other ingredients; and
(b) does not include the weight of any
other ingredient combined with cannabis or cannabis extract to
prepare topical or oral administrations, food, drink or another
product;
(5) "cannabis retailer" means a person that
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sells cannabis products to consumers, pursuant to a license
issued by the cannabis control division of the regulation and
licensing department pursuant to the Cannabis Regulation Act;
(6) "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 individual or group health maintenance
organization contract;
(7) "copayment" means a cost-sharing method
that requires an enrollee to pay a fixed dollar amount when
health care services are received, with the carrier paying the
balance of the allowable amount; provided that there may be
different copayment requirements for different types of
services under the same individual or group health maintenance
organization contract;
(8) "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 an individual or group
health maintenance organization contract;
(9) "debilitating medical condition" means:
(a) cancer;
(b) glaucoma;
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(c) multiple sclerosis;
(d) damage to the nervous tissue of the
spinal cord, with objective neurological indication of
intractable spasticity;
(e) seizure disorder, including
epilepsy;
(f) positive status for human
immunodeficiency virus or acquired immunodeficiency syndrome;
(g) admittance into hospice care in
accordance with rules promulgated by the department of health;
(h) amyotrophic lateral sclerosis;
(i) Crohn's disease;
(j) hepatitis C infection;
(k) Huntington's disease;
(l) inclusion body myositis;
(m) inflammatory autoimmune-mediated
arthritis;
(n) intractable nausea or vomiting;
(o) obstructive sleep apnea;
(p) painful peripheral neuropathy;
(q) Parkinson's disease;
(r) posttraumatic stress disorder;
(s) severe chronic pain;
(t) severe anorexia or cachexia;
(u) spasmodic torticollis;
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(v) ulcerative colitis; or
(w) any other medical condition, medical
treatment or disease as approved by the department of health;
(10) "generally accepted standards" means
standards of care and clinical practice, including clinical
practice guidelines and recommendations from professional
associations, that are generally recognized by health care
providers practicing in relevant clinical specialties;
(11) "medical cannabis" means cannabis
products used by a qualified patient or in accordance with the
Lynn and Erin Compassionate Use Act; and
(12) "qualified patient" means a resident of
New Mexico who holds a registry identification card pursuant to
the Lynn and Erin Compassionate Use Act.
B. An individual or group health insurance policy,
health care plan or certificate of health insurance delivered,
issued for delivery or renewed in this state shall provide
coverage for:
(1) medical cannabis that is consistent with
the coverage provided for medication that would otherwise be
prescribed in accordance with generally accepted standards to
treat the eligible insured's debilitating medical condition,
including cost-sharing requirements; and
(2) an adequate supply, as established by
department of health rule; provided that the eligible insured:
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(a) is a qualified patient; and
(b) obtains cannabis from a cannabis
retailer approved by the insurer.
C. An insurer shall provide:
(1) reimbursement to an eligible insured after
the submission of a claim in accordance with the process
established by the insurer's plan and in compliance with
department of health rule; or
(2) direct payment to a cannabis retailer
authorized by the insurer after submission of the claim in
accordance with the process established by the insurer's plan
and in compliance with department of health rule."
SECTION 4. A new section of Chapter 59A, Article 23 NMSA
1978 is enacted to read:
"[NEW MATERIAL] MEDICAL CANNABIS COVERAGE.--
A. As used in this section:
(1) "adequate supply" means an amount of
cannabis, in any form approved by the department of health,
possessed by a qualified patient that is determined by
department of health rule to be no more than reasonably
necessary to ensure the uninterrupted availability of cannabis
for a period of three months and that is derived solely from an
intrastate source;
(2) "cannabis":
(a) means all parts of the plant
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Cannabis containing a delta-9-tetrahydrocannabinol
concentration of more than three-tenths percent on a dry weight
basis, whether growing or not; the seeds of the plant; the
resin extracted from any part of the plant; and every compound,
manufacture, salt, derivative, mixture or preparation of the
plant, its seeds or its resin; and
(b) does not include the mature stalks
of the plant; fiber produced from the stalks; oil or cake made
from the seeds of the plant; any other compound, manufacture,
salt, derivative, mixture or preparation of the mature stalks,
fiber, oil or cake; the sterilized seed of the plant that is
incapable of germination; the weight of any other ingredient
combined with cannabis to prepare topical or oral
administrations, food, drink or another product; or hemp;
(3) "cannabis extract":
(a) means a product obtained by
separating resins from cannabis by solvent extraction using
solvents other than vegetable glycerin, such as butane, hexane,
isopropyl alcohol, ethanol or carbon dioxide; and
(b) does not include the weight of any
other ingredient combined with cannabis extract to prepare
topical or oral administrations, food, drink or another
product;
(4) "cannabis product":
(a) means a product that contains
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cannabis, including edible or topical products that may also
contain other ingredients; and
(b) does not include the weight of any
other ingredient combined with cannabis or cannabis extract to
prepare topical or oral administrations, food, drink or another
product;
(5) "cannabis retailer" means a person that
sells cannabis products to consumers, pursuant to a license
issued by the cannabis control division of the regulation and
licensing department pursuant to the Cannabis Regulation Act;
(6) "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 individual or group health maintenance
organization contract;
(7) "copayment" means a cost-sharing method
that requires an enrollee to pay a fixed dollar amount when
health care services are received, with the carrier paying the
balance of the allowable amount; provided that there may be
different copayment requirements for different types of
services under the same individual or group health maintenance
organization contract;
(8) "cost sharing" means a copayment,
coinsurance, deductible or any other form of financial
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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 an individual or group
health maintenance organization contract;
(9) "debilitating medical condition" means:
(a) cancer;
(b) glaucoma;
(c) multiple sclerosis;
(d) damage to the nervous tissue of the
spinal cord, with objective neurological indication of
intractable spasticity;
(e) seizure disorder, including
epilepsy;
(f) positive status for human
immunodeficiency virus or acquired immunodeficiency syndrome;
(g) admittance into hospice care in
accordance with rules promulgated by the department of health;
(h) amyotrophic lateral sclerosis;
(i) Crohn's disease;
(j) hepatitis C infection;
(k) Huntington's disease;
(l) inclusion body myositis;
(m) inflammatory autoimmune-mediated
arthritis;
(n) intractable nausea or vomiting;
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(o) obstructive sleep apnea;
(p) painful peripheral neuropathy;
(q) Parkinson's disease;
(r) posttraumatic stress disorder;
(s) severe chronic pain;
(t) severe anorexia or cachexia;
(u) spasmodic torticollis;
(v) ulcerative colitis; or
(w) any other medical condition, medical
treatment or disease as approved by the department of health;
(10) "generally accepted standards" means
standards of care and clinical practice, including clinical
practice guidelines and recommendations, that are generally
recognized by health care providers practicing in relevant
clinical specialties;
(11) "medical cannabis" means cannabis
products used by a qualified patient or in accordance with the
Lynn and Erin Compassionate Use Act; and
(12) "qualified patient" means a resident of
New Mexico who holds a registry identification card pursuant to
the Lynn and Erin Compassionate Use Act.
B. A group or blanket health insurance policy or
contract that is delivered, issued for delivery or renewed in
this state shall provide coverage for:
(1) medical cannabis that is consistent with
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the coverage provided for medication that would otherwise be
prescribed in accordance with generally accepted standards to
treat the eligible insured's debilitating medical condition,
including cost-sharing requirements; and
(2) an adequate supply, as established by
department of health rule; provided that the eligible insured:
(a) is a qualified patient; and
(b) obtains cannabis from a cannabis
retailer approved by the insurer.
C. An insurer shall provide:
(1) reimbursement to an eligible insured after
the submission of a claim in accordance with the process
established by the insurer's plan and in compliance with
department of health rule; or
(2) direct payment to a cannabis retailer
authorized by the insurer after submission of the claim in
accordance with the process established by the insurer's plan
and in compliance with department of health rule."
SECTION 5. A new section of the Health Maintenance
Organization Law is enacted to read:
"[NEW MATERIAL] MEDICAL CANNABIS COVERAGE.--
A. As used in this section:
(1) "adequate supply" means an amount of
cannabis, in any form approved by the department of health,
possessed by a qualified patient that is determined by
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department of health rule to be no more than reasonably
necessary to ensure the uninterrupted availability of cannabis
for a period of three months and that is derived solely from an
intrastate source;
(2) "cannabis":
(a) means all parts of the plant
Cannabis containing a delta-9-tetrahydrocannabinol
concentration of more than three-tenths percent on a dry weight
basis, whether growing or not; the seeds of the plant; the
resin extracted from any part of the plant; and every compound,
manufacture, salt, derivative, mixture or preparation of the
plant, its seeds or its resin; and
(b) does not include the mature stalks
of the plant; fiber produced from the stalks; oil or cake made
from the seeds of the plant; any other compound, manufacture,
salt, derivative, mixture or preparation of the mature stalks,
fiber, oil or cake; the sterilized seed of the plant that is
incapable of germination; the weight of any other ingredient
combined with cannabis to prepare topical or oral
administrations, food, drink or another product; or hemp;
(3) "cannabis extract":
(a) means a product obtained by
separating resins from cannabis by solvent extraction using
solvents other than vegetable glycerin, such as butane, hexane,
isopropyl alcohol, ethanol or carbon dioxide; and
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(b) does not include the weight of any
other ingredient combined with cannabis extract to prepare
topical or oral administrations, food, drink or another
product;
(4) "cannabis product":
(a) means a product that contains
cannabis, including edible or topical products that may also
contain other ingredients; and
(b) does not include the weight of any
other ingredient combined with cannabis or cannabis extract to
prepare topical or oral administrations, food, drink or another
product;
(5) "cannabis retailer" means a person that
sells cannabis products to consumers, pursuant to a license
issued by the cannabis control division of the regulation and
licensing department pursuant to the Cannabis Regulation Act;
(6) "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 individual or group health maintenance
organization contract;
(7) "copayment" means a cost-sharing method
that requires an enrollee to pay a fixed dollar amount when
health care services are received, with the carrier paying the
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balance of the allowable amount; provided that there may be
different copayment requirements for different types of
services under the same individual or group health maintenance
organization contract;
(8) "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 an individual or group
health maintenance organization contract;
(9) "debilitating medical condition" means:
(a) cancer;
(b) glaucoma;
(c) multiple sclerosis;
(d) damage to the nervous tissue of the
spinal cord, with objective neurological indication of
intractable spasticity;
(e) seizure disorder, including
epilepsy;
(f) positive status for human
immunodeficiency virus or acquired immunodeficiency syndrome;
(g) admittance into hospice care in
accordance with rules promulgated by the department of health;
(h) amyotrophic lateral sclerosis;
(i) Crohn's disease;
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(j) hepatitis C infection;
(k) Huntington's disease;
(l) inclusion body myositis;
(m) inflammatory autoimmune-mediated
arthritis;
(n) intractable nausea or vomiting;
(o) obstructive sleep apnea;
(p) painful peripheral neuropathy;
(q) Parkinson's disease;
(r) posttraumatic stress disorder;
(s) severe chronic pain;
(t) severe anorexia or cachexia;
(u) spasmodic torticollis;
(v) ulcerative colitis; or
(w) any other medical condition, medical
treatment or disease as approved by the department of health;
(10) "generally accepted standards" means
standards of care and clinical practice, including clinical
practice guidelines and recommendations from professional
associations, that are generally recognized by health care
providers practicing in relevant clinical specialties;
(11) "medical cannabis" means cannabis
products used by a qualified patient or in accordance with the
Lynn and Erin Compassionate Use Act; and
(12) "qualified patient" means a resident of
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New Mexico who holds a registry identification card pursuant to
the Lynn and Erin Compassionate Use Act.
B. An individual or group health maintenance
organization contract that is delivered, issued for delivery or
renewed in this state shall provide coverage for:
(1) medical cannabis that is consistent with
the coverage provided for medication that would otherwise be
prescribed in accordance with generally accepted standards to
treat the eligible enrollee's debilitating medical condition,
including cost-sharing requirements; and
(2) an adequate supply, as established by
department of health rule; provided that the eligible enrollee:
(a) is a qualified patient; and
(b) obtains cannabis from a cannabis
retailer approved by the insurer.
C. An insurer shall provide:
(1) reimbursement to an eligible enrollee
after the submission of a claim in accordance with the process
established by the carrier and in compliance with department of
health rule; or
(2) direct payment to a cannabis retailer
authorized by the carrier after submission of the claim in
accordance with the process established by the carrier and in
compliance with department of health rule."
SECTION 6. A new section of the Nonprofit Health Care
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Plan Law is enacted to read:
"[NEW MATERIAL] COVERAGE FOR MEDICAL CANNABIS.--
A. As used in this section:
(1) "adequate supply" means an amount of
cannabis, in any form approved by the department of health,
possessed by a qualified patient that is determined by
department of health rule to be no more than reasonably
necessary to ensure the uninterrupted availability of cannabis
for a period of three months and that is derived solely from an
intrastate source;
(2) "cannabis":
(a) means all parts of the plant
Cannabis containing a delta-9-tetrahydrocannabinol
concentration of more than three-tenths percent on a dry weight
basis, whether growing or not; the seeds of the plant; the
resin extracted from any part of the plant; and every compound,
manufacture, salt, derivative, mixture or preparation of the
plant, its seeds or its resin; and
(b) does not include the mature stalks
of the plant; fiber produced from the stalks; oil or cake made
from the seeds of the plant; any other compound, manufacture,
salt, derivative, mixture or preparation of the mature stalks,
fiber, oil or cake; the sterilized seed of the plant that is
incapable of germination; the weight of any other ingredient
combined with cannabis to prepare topical or oral
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administrations, food, drink or another product; or hemp;
(3) "cannabis extract":
(a) means a product obtained by
separating resins from cannabis by solvent extraction using
solvents other than vegetable glycerin, such as butane, hexane,
isopropyl alcohol, ethanol or carbon dioxide; and
(b) does not include the weight of any
other ingredient combined with cannabis extract to prepare
topical or oral administrations, food, drink or another
product;
(4) "cannabis product":
(a) means a product that contains
cannabis, including edible or topical products that may also
contain other ingredients; and
(b) does not include the weight of any
other ingredient combined with cannabis or cannabis extract to
prepare topical or oral administrations, food, drink or another
product;
(5) "cannabis retailer" means a person that
sells cannabis products to consumers, pursuant to a license
issued by the cannabis control division of the regulation and
licensing department pursuant to the Cannabis Regulation Act;
(6) "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
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coinsurance rates may differ for different types of services
under the same individual or group health maintenance
organization contract;
(7) "copayment" means a cost-sharing method
that requires an enrollee to pay a fixed dollar amount when
health care services are received, with the carrier paying the
balance of the allowable amount; provided that there may be
different copayment requirements for different types of
services under the same individual or group health maintenance
organization contract;
(8) "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 an individual or group
health maintenance organization contract;
(9) "debilitating medical condition" means:
(a) cancer;
(b) glaucoma;
(c) multiple sclerosis;
(d) damage to the nervous tissue of the
spinal cord, with objective neurological indication of
intractable spasticity;
(e) seizure disorder, including
epilepsy;
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(f) positive status for human
immunodeficiency virus or acquired immunodeficiency syndrome;
(g) admittance into hospice care in
accordance with rules promulgated by the department of health;
(h) amyotrophic lateral sclerosis;
(i) Crohn's disease;
(j) hepatitis C infection;
(k) Huntington's disease;
(l) inclusion body myositis;
(m) inflammatory autoimmune-mediated
arthritis;
(n) intractable nausea or vomiting;
(o) obstructive sleep apnea;
(p) painful peripheral neuropathy;
(q) Parkinson's disease;
(r) posttraumatic stress disorder;
(s) severe chronic pain;
(t) severe anorexia or cachexia;
(u) spasmodic torticollis;
(v) ulcerative colitis; or
(w) any other medical condition, medical
treatment or disease as approved by the department of health;
(10) "generally accepted standards" means
standards of care and clinical practice, including clinical
practice guidelines and recommendations from professional
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associations, that are generally recognized by health care
providers practicing in relevant clinical specialties;
(11) "medical cannabis" means cannabis
products used by a qualified patient or in accordance with the
Lynn and Erin Compassionate Use Act; and
(12) "qualified patient" means a resident of
New Mexico who holds a registry identification card pursuant to
the Lynn and Erin Compassionate Use Act.
B. An individual or group health care plan that is
delivered, issued for delivery or renewed in this state shall
provide coverage for:
(1) medical cannabis that is consistent with
the coverage provided for medication that would otherwise be
prescribed in accordance with generally recognized standards to
treat the eligible subscriber's debilitating medical condition,
including cost-sharing requirements; and
(2) an adequate supply, as established by
department of health rule; provided that the eligible
subscriber:
(a) is a qualified patient; and
(b) obtains cannabis from a cannabis
retailer approved by the insurer.
C. An insurer shall provide:
(1) reimbursement to an eligible subscriber
after the submission of a claim in accordance with the process
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established by the health care plan and in compliance with
department of health rule; or
(2) direct payment to a cannabis retailer
authorized by the health care plan after submission of the
claim in accordance with the process established by the health
care plan and in compliance with department of health rule."
SECTION 7. EFFECTIVE DATE.--The effective date of the
provisions of this act is January 1, 2026.
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