New Mexico 2025 Regular Session

New Mexico Senate Bill SB120 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	~~SHPAC/SB 120~~
2		-	~~Page 1~~
	1	+	underscored material = new
	2	+	[bracketed material] = delete
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	28	+	SENATE BILL 120
	29	+	57TH LEGISLATURE - STATE OF NEW MEXICO - FIRST SESSION, 2025
	30	+	INTRODUCED BY
	31	+	Martin Hickey and Jeff Steinborn
28	32		AN ACT
29	33		RELATING TO HEALTH; AMENDING SECTIONS OF THE HEALTH CARE
30		-	PURCHASING ACT AND NEW MEXICO INSURANCE CODE TO ADD AN
31		-	EXEMPTION FROM THE PROHIBITION ON COST SHARING FOR BEHAVIORAL
32		-	HEALTH SERVICES FOR CERTAIN PLANS.
	34	+	PURCHASING ACT AND NEW MEXICO INSURANCE CODE TO PERMANENTLY
	35	+	ELIMINATE BEHAVIORAL HEALTH SERVICES COST SHARING.
33	36		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
34	37		SECTION 1. Section 13-7-26 NMSA 1978 (being Laws 2021,
35	38		Chapter 136, Section 3) is amended to read:
36		-	"13-7-26. BEHAVIORAL HEALTH SERVICES--ELIMINATION OF
37		-	~~COST~~ SHARING.--
38		-	A. Group health coverage, ~~including any form of~~
39		-	self-insurance, offered, issued or ~~renewed under the Health~~
40		-	Care Purchasing Act that offers ~~coverage of behavioral health~~
41		-	services shall not impose cost ~~sharing on those behavioral~~
42		-	health services ~~in network~~.
	39	+	"13-7-26. BEHAVIORAL HEALTH SERVICES--ELIMINATION OF COST
	40	+	SHARING.--
	41	+	A. [Until January 1, 2027 ] Group health coverage,
	42	+	including any form of self-insurance, offered, issued or
	43	+	renewed under the Health Care Purchasing Act that offers
	44	+	coverage of behavioral health services shall not impose cost
	45	+	sharing on those behavioral health services.
43	46		B. For the purposes of this section:
44		-	(1) "behavioral health services" means
45		-	professional and ancillary services for the treatment,
46		-	habilitation, prevention and identification of mental
47		-	illnesses, substance abuse disorders and trauma spectrum
48		-	disorders, including inpatient, detoxification, residential
49		-	treatment and partial hospitalization, intensive outpatient
50		-	therapy, outpatient therapy and all medications, including
51		-	brand-name pharmacy drugs when generics are unavailable; SHPAC/SB 120
52		-	Page 2
	47	+	.229332.1 underscored material = new
	48	+	[bracketed material] = delete
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78		-	(2) "coinsurance" means a cost-sharing
79		-	method that requires an enrollee to pay a stated percentage
80		-	of medical expenses after any deductible amount is paid;
81		-	provided that coinsurance rates may differ for different
82		-	types of services under the same group health plan;
	74	+	(1) "behavioral health services" means
	75	+	professional and ancillary services for the treatment,
	76	+	habilitation, prevention and identification of mental
	77	+	illnesses, substance abuse disorders and trauma spectrum
	78	+	disorders, including inpatient, detoxification, residential
	79	+	treatment and partial hospitalization, intensive outpatient
	80	+	therapy, outpatient and all medications, including brand-name
	81	+	pharmacy drugs when generics are unavailable;
	82	+	(2) "coinsurance" means a cost-sharing method
	83	+	that requires an enrollee to pay a stated percentage of medical
	84	+	expenses after any deductible amount is paid; provided that
	85	+	coinsurance rates may differ for different types of services
	86	+	under the same group health plan;
83	87		(3) "copayment" means a cost-sharing method
84		-	that requires an enrollee to pay a fixed dollar amount
85		-	when health care services are received, with the plan
86		-	administrator paying the balance of the allowable amount;
87		-	provided that there may be different copayment requirements
88		-	for different types of services under the same group health
89		-	plan; and
	88	+	that requires an enrollee to pay a fixed dollar amount when
	89	+	health care services are received, with the plan administrator
	90	+	paying the balance of the allowable amount; provided that there
	91	+	may be different copayment requirements for different types of
	92	+	services under the same group health plan; and
90	93		(4) "cost sharing" means a copayment,
91	94		coinsurance, deductible or any other form of financial
92		-	obligation of an enrollee other than a premium or a share of
93		-	a premium, or any combination of any of these financial
94		-	obligations, as defined by the terms of a group health plan.
95		-	C. The provisions of this section do not apply to
96		-	excepted benefit plans as provided under the Short-Term
97		-	Health Plan and Excepted Benefit Act, catastrophic plans as
98		-	defined under 42 USCA Section 18022(e) or high-deductible
99		-	health plans with health savings accounts until an enrollee's
100		-	deductible has been met, unless otherwise permitted by
101		-	federal law."
102		-	SECTION 2. Section 59A-22-57 NMSA 1978 (being SHPAC/SB 120
103		-	Page 3
	95	+	obligation of an enrollee other than a premium or a share of a
	96	+	premium, or any combination of any of these financial
	97	+	obligations, as defined by the terms of a group health plan."
	98	+	SECTION 2. Section 59A-22-57 NMSA 1978 (being Laws 2021,
	99	+	.229332.1
	100	+	- 2 - underscored material = new
	101	+	[bracketed material] = delete
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129		-	~~Laws 2021,~~ Chapter 136, Section 6) is amended to read:
	127	+	Chapter 136, Section 6) is amended to read:
130	128		"59A-22-57. BEHAVIORAL HEALTH SERVICES--ELIMINATION OF
131	129		COST SHARING.--
132		-	A. An individual or group health insurance policy,
133		-	health care plan or certificate of health insurance that is
134		-	delivered, issued for delivery or renewed in this state that
135		-	offers coverage of behavioral health services shall not
136		-	impose cost sharing on those behavioral health services.
	130	+	A. [Until January 1, 2027 ] An individual or group
	131	+	health insurance policy, health care plan or certificate of
	132	+	health insurance that is delivered, issued for delivery or
	133	+	renewed in this state that offers coverage of behavioral health
	134	+	services shall not impose cost sharing on those behavioral
	135	+	health services.
137	136		B. For the purposes of this section:
138	137		(1) "behavioral health services" means
139	138		professional and ancillary services for the treatment,
140	139		habilitation, prevention and identification of mental
141	140		illnesses, substance abuse disorders and trauma spectrum
142	141		disorders, including inpatient, detoxification, residential
143	142		treatment and partial hospitalization, intensive outpatient
144		-	therapy, outpatient therapy and all medications, including
145		-	brand-name pharmacy drugs when generics are unavailable;
146		-	(2) "coinsurance" means a cost-sharing
147		-	method that requires the insured to pay a stated percentage
148		-	of medical expenses after any deductible amount is paid;
149		-	provided that coinsurance rates may differ for different
150		-	types of services under the same individual or group health
151		-	insurance policy, health care plan or certificate of health
152		-	insurance;
153		-	(3) "copayment" means a cost-sharing method SHPAC/SB 120
154		-	Page 4
	143	+	therapy, outpatient and all medications, including brand-name
	144	+	pharmacy drugs when generics are unavailable;
	145	+	(2) "coinsurance" means a cost-sharing method
	146	+	that requires the insured to pay a stated percentage of medical
	147	+	expenses after any deductible amount is paid; provided that
	148	+	coinsurance rates may differ for different types of services
	149	+	under the same individual or group health insurance policy,
	150	+	health care plan or certificate of health insurance;
	151	+	(3) "copayment" means a cost-sharing method
	152	+	.229332.1
	153	+	- 3 - underscored material = new
	154	+	[bracketed material] = delete
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180	180		that requires the insured to pay a fixed dollar amount when
181		-	health care services are received, with the insurer paying
182		-	~~the~~ balance of the allowable amount; provided that there may
183		-	be different copayment requirements for different types of
	181	+	health care services are received, with the insurer paying the
	182	+	balance of the allowable amount; provided that there may be
	183	+	different copayment requirements for different types of
184	184		services under the same individual or group health insurance
185	185		policy, health care plan or certificate of health insurance;
186	186		and
187	187		(4) "cost sharing" means a copayment,
188	188		coinsurance, deductible or any other form of financial
189		-	obligation of the insured other than a premium or a share
190		-	of a premium, or any combination of any of these financial
191		-	obligations, as defined by the terms of an individual or
192		-	group health insurance policy, health care plan or
193		-	certificate of health insurance.
194		-	C. The provisions of this section do not apply
195		-	to excepted benefit plans as provided under the Short-Term
196		-	Health Plan and Excepted Benefit Act, catastrophic plans as
197		-	defined under 42 USCA Section 18022(e) or high-deductible
198		-	health plans with health savings accounts until an insured's
199		-	deductible has been met, unless otherwise permitted by
200		-	federal law."
201		-	SECTION 3. Section 59A-23-16 NMSA 1978 (being
202		-	Laws 2021, Chapter 136, Section 7) is amended to read:
	189	+	obligation of the insured other than a premium or a share of a
	190	+	premium, or any combination of any of these financial
	191	+	obligations, as defined by the terms of an individual or group
	192	+	health insurance policy, health care plan or certificate of
	193	+	health insurance."
	194	+	SECTION 3. Section 59A-23-16 NMSA 1978 (being Laws 2021,
	195	+	Chapter 136, Section 7) is amended to read:
203	196		"59A-23-16. BEHAVIORAL HEALTH SERVICES--ELIMINATION OF
204		-	COST SHARING.-- SHPAC/SB 120
205		-	Page 5
	197	+	COST SHARING.--
	198	+	A. [Until January 1, 2027 ] A group or blanket
	199	+	health insurance policy, health care plan or certificate of
	200	+	health insurance that is delivered, issued for delivery or
	201	+	renewed in this state that offers coverage of behavioral health
	202	+	services shall not impose cost sharing on those behavioral
	203	+	health services.
	204	+	B. For the purposes of this section:
	205	+	.229332.1
	206	+	- 4 - underscored material = new
	207	+	[bracketed material] = delete
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231		-	A. A group or blanket health insurance policy,
232		-	health care plan or certificate of health insurance that is
233		-	delivered, issued for delivery or renewed in this state that
234		-	offers coverage of behavioral health services shall not
235		-	impose cost sharing on those behavioral health services in
236		-	network.
237		-	B. For the purposes of this section:
238	233		(1) "behavioral health services" means
239	234		professional and ancillary services for the treatment,
240	235		habilitation, prevention and identification of mental
241	236		illnesses, substance abuse disorders and trauma spectrum
242	237		disorders, including inpatient, detoxification, residential
243	238		treatment and partial hospitalization, intensive outpatient
244		-	therapy, outpatient therapy and all medications, including
245		-	brand-name pharmacy drugs when generics are unavailable;
246		-	(2) "coinsurance" means a cost-sharing
247		-	method that requires a covered person to pay a stated
248		-	percentage of medical expenses after any deductible amount
249		-	is paid; provided that coinsurance rates may differ for
250		-	different types of services under the same group or blanket
251		-	health insurance policy, health care plan or certificate of
252		-	health insurance;
	239	+	therapy, outpatient and all medications, including brand-name
	240	+	pharmacy drugs when generics are unavailable;
	241	+	(2) "coinsurance" means a cost-sharing method
	242	+	that requires a covered person to pay a stated percentage of
	243	+	medical expenses after any deductible amount is paid; provided
	244	+	that coinsurance rates may differ for different types of
	245	+	services under the same group or blanket health insurance
	246	+	policy, health care plan or certificate of health insurance;
253	247		(3) "copayment" means a cost-sharing method
254	248		that requires a covered person to pay a fixed dollar amount
255		-	when health care services are received, with the insurer SHPAC/SB 120
256		-	Page 6
	249	+	when health care services are received, with the insurer paying
	250	+	the balance of the allowable amount; provided that there may be
	251	+	different copayment requirements for different types of
	252	+	services under the same group or blanket health insurance
	253	+	policy, health care plan or certificate of health insurance;
	254	+	and
	255	+	(4) "cost sharing" means a copayment,
	256	+	coinsurance, deductible or any other form of financial
	257	+	obligation of a covered person other than a premium or a share
	258	+	.229332.1
	259	+	- 5 - underscored material = new
	260	+	[bracketed material] = delete
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282		-	paying the balance of the allowable amount; provided that
283		-	there may be different copayment requirements for different
284		-	types of services under the same group or blanket health
285		-	insurance policy, health care plan or certificate of health
286		-	insurance; and
287		-	(4) "cost sharing" means a copayment,
288		-	coinsurance, deductible or any other form of financial
289		-	obligation of a covered person other than a premium or a
290		-	share of a premium, or any combination of any of these
291		-	financial obligations, as defined by the terms of a group
292		-	or blanket health insurance policy, health care plan or
293		-	certificate of health insurance.
294		-	C. The provisions of this section do not apply
295		-	to excepted benefit plans as provided under the Short-Term
296		-	Health Plan and Excepted Benefit Act, catastrophic plans as
297		-	defined under 42 USCA Section 18022(e) or high-deductible
298		-	health plans with health savings accounts until a covered
299		-	person's deductible has been met, unless otherwise permitted
300		-	by federal law."
301		-	SECTION 4. Section 59A-46-57 NMSA 1978 (being
302		-	Laws 2021, Chapter 136, Section 8) is amended to read:
	286	+	of a premium, or any combination of any of these financial
	287	+	obligations, as defined by the terms of a group or blanket
	288	+	health insurance policy, health care plan or certificate of
	289	+	health insurance."
	290	+	SECTION 4. Section 59A-46-57 NMSA 1978 (being Laws 2021,
	291	+	Chapter 136, Section 8) is amended to read:
303	292		"59A-46-57. BEHAVIORAL HEALTH SERVICES--ELIMINATION OF
304	293		COST SHARING.--
305		-	A. An individual or group health maintenance
306		-	organization contract that is delivered, issued for delivery SHPAC/SB 120
307		-	Page 7
	294	+	A. [Until January 1, 2027 ] An individual or group
	295	+	health maintenance organization contract that is delivered,
	296	+	issued for delivery or renewed in this state that offers
	297	+	coverage of behavioral health services shall not impose cost
	298	+	sharing on those behavioral health services.
	299	+	B. For the purposes of this section:
	300	+	(1) "behavioral health services" means
	301	+	professional and ancillary services for the treatment,
	302	+	habilitation, prevention and identification of mental
	303	+	illnesses, substance abuse disorders and trauma spectrum
	304	+	disorders, including inpatient, detoxification, residential
	305	+	treatment and partial hospitalization, intensive outpatient
	306	+	therapy, outpatient and all medications, including brand-name
	307	+	pharmacy drugs when generics are unavailable;
	308	+	(2) "coinsurance" means a cost-sharing method
	309	+	that requires an enrollee to pay a stated percentage of medical
	310	+	expenses after any deductible amount is paid; provided that
	311	+	.229332.1
	312	+	- 6 - underscored material = new
	313	+	[bracketed material] = delete
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333		-	or renewed in this state that offers coverage of behavioral
334		-	health services shall not impose cost sharing on those
335		-	behavioral health services in network.
336		-	B. For the purposes of this section:
337		-	(1) "behavioral health services" means
338		-	professional and ancillary services for the treatment,
339		-	habilitation, prevention and identification of mental
340		-	illnesses, substance abuse disorders and trauma spectrum
341		-	disorders, including inpatient, detoxification, residential
342		-	treatment and partial hospitalization, intensive outpatient
343		-	therapy, outpatient therapy and all medications, including
344		-	brand-name pharmacy drugs when generics are unavailable;
345		-	(2) "coinsurance" means a cost-sharing
346		-	method that requires an enrollee to pay a stated percentage
347		-	of medical expenses after any deductible amount is paid;
348		-	provided that coinsurance rates may differ for different
349		-	types of services under the same individual or group health
350		-	maintenance organization contract;
	339	+	coinsurance rates may differ for different types of services
	340	+	under the same individual or group health maintenance
	341	+	organization contract;
351	342		(3) "copayment" means a cost-sharing method
352	343		that requires an enrollee to pay a fixed dollar amount when
353		-	health care services are received, with the carrier paying
354		-	the balance of the allowable amount; provided that there
355		-	may be different copayment requirements for different types
356		-	of services under the same individual or group health
357		-	maintenance organization contract; and SHPAC/SB 120
358		-	Page 8
	344	+	health care services are received, with the carrier paying the
	345	+	balance of the allowable amount; provided that there may be
	346	+	different copayment requirements for different types of
	347	+	services under the same individual or group health maintenance
	348	+	organization contract; and
	349	+	(4) "cost sharing" means a copayment,
	350	+	coinsurance, deductible or any other form of financial
	351	+	obligation of an enrollee other than a premium or a share of a
	352	+	premium, or any combination of any of these financial
	353	+	obligations, as defined by the terms of an individual or group
	354	+	health maintenance organization contract."
	355	+	SECTION 5. Section 59A-47-51 NMSA 1978 (being Laws 2021,
	356	+	Chapter 136, Section 9) is amended to read:
	357	+	"59A-47-51. BEHAVIORAL HEALTH SERVICES--ELIMINATION OF
	358	+	COST SHARING.--
	359	+	A. [Until January 1, 2027 ] An individual or group
	360	+	health care plan that is delivered, issued for delivery or
	361	+	renewed in this state that offers coverage of behavioral health
	362	+	services shall not impose cost sharing on those behavioral
	363	+	health services.
	364	+	.229332.1
	365	+	- 7 - underscored material = new
	366	+	[bracketed material] = delete
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	392	+	B. For the purposes of this section:
	393	+	(1) "behavioral health services" means
	394	+	professional and ancillary services for the treatment,
	395	+	habilitation, prevention and identification of mental
	396	+	illnesses, substance abuse disorders and trauma spectrum
	397	+	disorders, including inpatient, detoxification, residential
	398	+	treatment and partial hospitalization, intensive outpatient
	399	+	therapy, outpatient and all medications, including brand-name
	400	+	pharmacy drugs when generics are unavailable;
	401	+	(2) "coinsurance" means a cost-sharing method
	402	+	that requires a subscriber to pay a stated percentage of
	403	+	medical expenses after any deductible amount is paid; provided
	404	+	that coinsurance rates may differ for different types of
	405	+	services under the same individual or group health care plan;
	406	+	(3) "copayment" means a cost-sharing method
	407	+	that requires a subscriber to pay a fixed dollar amount when
	408	+	health care services are received, with the health care plan
	409	+	paying the balance of the allowable amount; provided that there
	410	+	may be different copayment requirements for different types of
	411	+	services under the same individual or group health care plan;
	412	+	and
384	413		(4) "cost sharing" means a copayment,
385	414		coinsurance, deductible or any other form of financial
386		-	obligation of an enrollee other than a premium or a share of
387		-	a premium, or any combination of any of these financial
388		-	obligations, as defined by the terms of an individual or
389		-	group health maintenance organization contract.
390		-	C. The provisions of this section do not apply
391		-	to excepted benefit plans as provided under the Short-Term
392		-	Health Plan and Excepted Benefit Act, catastrophic plans as
393		-	defined under 42 USCA Section 18022(e) or high-deductible
394		-	health plans with health savings accounts until an enrollee's
395		-	deductible has been met, unless otherwise permitted by
396		-	federal law."
397		-	SECTION 5. Section 59A-47-51 NMSA 1978 (being
398		-	Laws 2021, Chapter 136, Section 9) is amended to read:
399		-	"59A-47-51. BEHAVIORAL HEALTH SERVICES--ELIMINATION OF
400		-	COST SHARING.--
401		-	A. An individual or group health care plan that is
402		-	delivered, issued for delivery or renewed in this state that
403		-	offers coverage of behavioral health services shall not
404		-	impose cost sharing on those behavioral health services in
405		-	network.
406		-	B. For the purposes of this section:
407		-	(1) "behavioral health services" means
408		-	professional and ancillary services for the treatment, SHPAC/SB 120
409		-	Page 9
	415	+	obligation of a subscriber other than a premium or a share of a
	416	+	premium, or any combination of any of these financial
	417	+	.229332.1
	418	+	- 8 - underscored material = new
	419	+	[bracketed material] = delete
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435		-	habilitation, prevention and identification of mental
436		-	illnesses, substance abuse disorders and trauma spectrum
437		-	disorders, including inpatient, detoxification, residential
438		-	treatment and partial hospitalization, intensive outpatient
439		-	therapy, outpatient therapy and all medications, including
440		-	brand-name pharmacy drugs when generics are unavailable;
441		-	(2) "coinsurance" means a cost-sharing
442		-	method that requires a subscriber to pay a stated percentage
443		-	of medical expenses after any deductible amount is paid;
444		-	provided that coinsurance rates may differ for different
445		-	types of services under the same individual or group health
446		-	care plan;
447		-	(3) "copayment" means a cost-sharing method
448		-	that requires a subscriber to pay a fixed dollar amount when
449		-	health care services are received, with the health care plan
450		-	paying the balance of the allowable amount; provided that
451		-	there may be different copayment requirements for different
452		-	types of services under the same individual or group health
453		-	care plan; and
454		-	(4) "cost sharing" means a copayment,
455		-	coinsurance, deductible or any other form of financial
456		-	obligation of a subscriber other than a premium or a share
457		-	of a premium, or any combination of any of these financial
458		-	obligations, as defined by the terms of an individual or
459		-	group health care plan. SHPAC/SB 120
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486		-	C. The provisions of this section do not apply
487		-	to excepted benefit plans as provided under the Short-Term
488		-	Health Plan and Excepted Benefit Act, catastrophic plans as
489		-	defined under 42 USCA Section 18022(e) or high-deductible
490		-	health plans with health savings accounts until a
491		-	subscriber's deductible has been met, unless otherwise
492		-	permitted by federal law."
	445	+	obligations, as defined by the terms of an individual or group
	446	+	health care plan."
493	447		SECTION 6. EFFECTIVE DATE.--The effective date of the
494	448		provisions of this act is January 1, 2026.
	449	+	- 9 -
	450	+	.229332.1