Overview
New Mexico has made strides in healthcare price transparency and cost control. After a legislative mandate was enacted to establish an all-payer claims database, the state began its implementation with budget allotted in the 2019-2020 fiscal year. In recent terms, New Mexico also passed the Surprise Billing Protection Act, which requires a provider to refund to the covered person the amount paid in excess of the in-network cost-sharing amount within forty-five calendar days of receipt of payment. The consumer protection applies to both emergency and non-emergency services.
To increase healthcare access and reduce costs, New Mexico has enacted robust telehealth coverage laws that requires reimbursement, cost-sharing, and coverage parity for telehealth services. Additionally, the legislature enacted legislation that ensures insurance coverage for individuals with pre-existing conditions, regardless of mandates under the Affordable Care Act. In 2021, the state transitioned from the federal ACA exchange and launched its own-state run marketplace, beWellNM. The new state-based exchange offers plans from five insurers, more options than provided in most of the other states.
In 2024, New Mexico passed SB15, establishing a mandatory process for examining proposed acquisitions and changes in the control of hospitals as well as other health care mergers, acquisitions, and significant changes in control of health care entities, including health insurance entities. New Mexico also passed bills to address pharmaceutical issues, including HB33, which created new prescription drug price transparency requirements, and HB165 requiring Medicaid managed care organizations to reimburse community-based pharmacy providers for the full cost of prescription drugs plus a professional dispensing fee. The state also considered legislation that would have required county hospitals and contracting hospitals in New Mexico to accept all health benefit plans available through the New Mexico health insurance exchange, and legislation that would have created new transparency requirements for hospitals or providers of management services for hospitals, but these bills ultimately failed.
See below for an overview of existing New Mexico state mandates. Click on citation tab for detailed information of specific statutes (click link to download statute text).
State Action
Latest Legislative Session: 1/17/2023 - 3/18/2023 (2023 term). *Current session bill updates are ongoing. Check back weekly for updates.
HB 293 (see companion bill SB 290) – New Mexico
Introduced: 2023 Status: Inactive / Dead
House Bill 293 appropriates $400 thousand from the general fund to Legislative Council Service for the purpose of hiring a contractor to analyze healthcare cost drivers and analyze the feasibility of applying to the New …
HB 295 (see companion bill SB 279) – New Mexico
Introduced: 2019 Status: Inactive / Dead
HEALTH SECURITY ACT: The commission shall dopt a transition plan to ensure the seamless transition of health security plan beneficiaries from other sources of coverage, public and private and propose health security plan premium rates …
HB 306 – New Mexico
Introduced: 2024 Status: In Process
Relating to hospitals; requiring financial transparency reports from corporations doing business in New Mexico as hospitals or providers of management services for hospitals that seek the benefit of monetary caps on damages provided by New …
HB 323 – New Mexico
Introduced: 2020 Status: Inactive / Dead
House Bill 323 (HB323) would appropriate $1 million to the Human Services Department (HSD) to increase the Medicaid reimbursement rates for air ambulance providers.
HB 33 – New Mexico
Introduced: 2024 Status: In Process
Relating to prescription drugs; enacting the prescription drug price transparency act to increase transparency across the prescription drug supply chain; requiring prescription drug manufacturers, pharmacy services administrative organizations, health insurers and pharmacy benefits managers to …
N.M. Stat § 59A-42A-2. Definitions: Provider Service Network Act – New Mexico
Introduced: Status: Enacted
Provides definitions for sections 59A-42A-1 through 59A-42A-9.
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N.M. Stat § 59A-2-8. General powers and duties of superintendent: Office of Superintendent of Insurance – New Mexico
Introduced: Status: Enacted
Provision governs the powers and duties of the superintendent of insurance including the power to conduct examinations.
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N.M. Stat § 59A-23-2. Blanket health insurance: Group and Blanket Health Insurance Contracts – New Mexico
Introduced: Status: Enacted
Blanket health insurance is declared to be that form of health insurance covering special groups of not fewer than ten persons as enumerated in one of the following paragraphs.
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N.M. Stat § 59A-54-4. Pool created; board: Medical Insurance Pool Act – New Mexico
Introduced: Status: Enacted
There is created a nonprofit entity to be known as the “New Mexico medical insurance pool”. All insurers shall organize and remain members of the pool as a condition of their authority to transact insurance …
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N.M. Stat §§ 53-14-1 through 53-14-7: Business Corporations; Mergers and Consolidations – New Mexico
Introduced: Status: Enacted
Provisions governing mergers and acquistions involving business corporations.
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Federal Trade Commission and State of Idaho v. St. Luke’s Health System, Ltd and Saltzer Medical Group, P.A. – California, Connecticut, Delaware, Idaho, Illinois, Iowa, Kentucky, Maine, Maryland, Mississippi, Montana, Nevada, New Mexico, Oregon, Pennsylvania, Tennessee, Washington
District Court: District of Idaho Status: Decided
In March 2013, the FTC and the Idaho Attorney General filed a joint complaint challenging the merger betweenSt. Luke’s Health System, Idaho’s largest health system, …
In re: Suboxone Antitrust Litigation (State of Wisconsin, et al. v. Indivior Inc, et al.) – Alabama, Alaska, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Utah, Virginia, Washington, West Virginia, Wisconsin
District Court: E.D. Pennsylvania Status: Pending
In September 2016, 35 state attorneys general and the District of Columbia brought a multi-district case against pharmaceutical manufacturer Indivior, MonoSol RX et al., alleging …
In Re: Generic Pharmaceuticals Pricing Antitrust Litigation – Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin
District Court: Eastern District of Pennsylvania Status: Pending
Plaintiffs are attorney generals from 48 states, Puerto Rico, and the District of Columbia, as well as classes of private plaintiffs that filed an antitrust …
Additional Resources
STATE BUDGET
New Mexico’s fiscal year begins on July 1 and ends on June 30. New Mexico enacts its annual budget during the regular legislative session. To view information about New Mexico’s state budget, click here.
REGULATION & ENFORCEMENT
- New Mexico was one of 16 states to file an amicus brief supporting the FTC’s winning position in the Ninth Circuit appeal of St. Luke’s Health Care Sys. v. FTC, No. 14-35173 (March 7, 2014), decided February 10, 2015. The States’ brief stated that the acceleration of health care costs due to the growth of large health care provider systems had become a matter of grave concern for the states.
KEY RESOURCES
- New Mexico Legislature
- New Mexico Office of the Attorney General
- New Mexico Office of the Superintendent of Insurance