New Mexico 2025 Regular Session

New Mexico Senate Bill SB297 Compare Versions

Only one version of the bill is available at this time.

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28	28	SENATE BILL 297
29	29	57
30	30	TH LEGISLATURE
31	31	-
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33	33	STATE
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35	35	OF
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37	37	NEW
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39	39	MEXICO
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42	42	FIRST SESSION
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45	45	2025
46	46	INTRODUCED BY
47	47	Nicole Tobiassen and Jay C. Block and Katy M. Duhigg
48	48	and Linda M. López
49	49	AN ACT
50	50	RELATING TO HEALTH CARE; REQUIRING THE HEALTH CARE AUTHORITY TO
51	51	CONDUCT REGIONAL COMMERCIAL INSURANCE MARKET ASSESSMENTS;
52	52	REQUIRING INCREASED MEDICAID REIMBURSEMENT FOR HEALTH CARE
53	53	SERVICES.
54	54	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
55	55	SECTION 1. A new section of the Public Assistance Act is
56	56	enacted to read:
57	57	"[NEW MATERIAL] MARKET ASSESSMENTS REQUIRED.--
58	58	A. By July 1, 2026 and every two years thereafter,
59	59	the authority shall conduct a market assessment to determine
60	60	the regional average commercial insurance reimbursement rate
61	61	for all health care services provided in Arizona, Colorado,
62	62	Utah, Oklahoma and Texas that are covered by the New Mexico
63	63	medicaid program.
64	64	.229810.3 underscored material = new
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91	91	B. The medicaid reimbursement rate for all health
92	92	care services that are covered by the New Mexico medicaid
93	93	program shall be the greater of:
94	94	(1) two hundred percent of the medicare
95	95	reimbursement rate for the equivalent service; or
96	96	(2) the regional average commercial insurance
97	97	reimbursement rate for the service.
98	98	C. Using the medicaid reimbursement rate for each
99	99	health care service as of July 1, 2024 as a baseline for
100	100	comparison, all health care entities that receive increases in
101	101	medicaid reimbursement pursuant to this section shall ensure
102	102	that at least seventy-five percent of the increase in
103	103	reimbursement revenue is used to:
104	104	(1) provide increased compensation to health
105	105	care workers and other employees who interact directly with
106	106	patients; or
107	107	(2) hire additional health care workers and
108	108	other employees who interact directly with patients.
109	109	D. For the purposes of this section:
110	110	(1) "health care entity" means an entity,
111	111	other than an individual, that is licensed to provide any form
112	112	of health care in the state, including a hospital, clinic,
113	113	hospice agency, home health agency, long-term care agency,
114	114	pharmacy, group medical practice, medical home or any similar
115	115	entity;
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144	144	(2) "medicaid" means the federal-state program
145	145	administered by the authority pursuant to Title 19 or Title 21
146	146	of the federal Social Security Act; and
147	147	(3) "medicare" means coverage provided
148	148	pursuant to part A or part B of Title 18 of the federal Social
149	149	Security Act, as amended."
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