underscored material = new
[bracketed material] = delete
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
SENATE BILL 120
57TH LEGISLATURE - STATE OF NEW MEXICO - FIRST SESSION, 2025
INTRODUCED BY
Martin Hickey and Jeff Steinborn
AN ACT
RELATING TO HEALTH; AMENDING SECTIONS OF THE HEALTH CARE
PURCHASING ACT AND NEW MEXICO INSURANCE CODE TO PERMANENTLY
ELIMINATE BEHAVIORAL HEALTH SERVICES COST SHARING.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
SECTION 1. Section 13-7-26 NMSA 1978 (being Laws 2021,
Chapter 136, Section 3) is amended to read:
"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:
.229332.1 underscored material = new
[bracketed material] = delete
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
(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."
SECTION 2. Section 59A-22-57 NMSA 1978 (being Laws 2021,
.229332.1
- 2 - underscored material = new
[bracketed material] = delete
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Chapter 136, Section 6) is amended to read:
"59A-22-57. BEHAVIORAL HEALTH SERVICES--ELIMINATION OF
COST SHARING.--
A. [Until January 1, 2027 ] 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 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 the insured 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 insurance policy,
health care plan or certificate of health insurance;
(3) "copayment" means a cost-sharing method
.229332.1
- 3 - underscored material = new
[bracketed material] = delete
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
that requires the insured to pay a fixed dollar amount when
health care services are received, with the insurer 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 insurance
policy, health care plan or certificate of health insurance;
and
(4) "cost sharing" means a copayment,
coinsurance, deductible or any other form of financial
obligation of the insured 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 insurance policy, health care plan or certificate of
health insurance."
SECTION 3. Section 59A-23-16 NMSA 1978 (being Laws 2021,
Chapter 136, Section 7) is amended to read:
"59A-23-16. BEHAVIORAL HEALTH SERVICES--ELIMINATION OF
COST SHARING.--
A. [Until January 1, 2027 ] A group or blanket
health insurance policy, health care plan or certificate of
health insurance that is delivered, issued for delivery or
renewed in this state that offers coverage of behavioral health
services shall not impose cost sharing on those behavioral
health services.
B. For the purposes of this section:
.229332.1
- 4 - underscored material = new
[bracketed material] = delete
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
(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 a covered person 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 or blanket health insurance
policy, health care plan or certificate of health insurance;
(3) "copayment" means a cost-sharing method
that requires a covered person to pay a fixed dollar amount
when health care services are received, with the insurer paying
the balance of the allowable amount; provided that there may be
different copayment requirements for different types of
services under the same group or blanket health insurance
policy, health care plan or certificate of health insurance;
and
(4) "cost sharing" means a copayment,
coinsurance, deductible or any other form of financial
obligation of a covered person other than a premium or a share
.229332.1
- 5 - underscored material = new
[bracketed material] = delete
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
of a premium, or any combination of any of these financial
obligations, as defined by the terms of a group or blanket
health insurance policy, health care plan or certificate of
health insurance."
SECTION 4. Section 59A-46-57 NMSA 1978 (being Laws 2021,
Chapter 136, Section 8) is amended to read:
"59A-46-57. BEHAVIORAL HEALTH SERVICES--ELIMINATION OF
COST SHARING.--
A. [Until January 1, 2027 ] An individual or group
health maintenance organization contract that is delivered,
issued for delivery or renewed in this state 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
.229332.1
- 6 - underscored material = new
[bracketed material] = delete
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
coinsurance rates may differ for different types of services
under the same individual or group health maintenance
organization contract;
(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 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; 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 an individual or group
health maintenance organization contract."
SECTION 5. Section 59A-47-51 NMSA 1978 (being Laws 2021,
Chapter 136, Section 9) is amended to read:
"59A-47-51. BEHAVIORAL HEALTH SERVICES--ELIMINATION OF
COST SHARING.--
A. [Until January 1, 2027 ] An individual or group
health care plan that is delivered, issued for delivery or
renewed in this state that offers coverage of behavioral health
services shall not impose cost sharing on those behavioral
health services.
.229332.1
- 7 - underscored material = new
[bracketed material] = delete
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
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 a subscriber 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 care plan;
(3) "copayment" means a cost-sharing method
that requires a subscriber to pay a fixed dollar amount when
health care services are received, with the health care plan
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 care plan;
and
(4) "cost sharing" means a copayment,
coinsurance, deductible or any other form of financial
obligation of a subscriber other than a premium or a share of a
premium, or any combination of any of these financial
.229332.1
- 8 - underscored material = new
[bracketed material] = delete
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
obligations, as defined by the terms of an individual or group
health care plan."
SECTION 6. EFFECTIVE DATE.--The effective date of the
provisions of this act is January 1, 2026.
- 9 -
.229332.1