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 100 – New Mexico
Introduced: 2020 Status: Enacted
The House Judiciary Committee Substitute for House Bill 100 would amend certain provisions of the New Mexico Health Insurance Exchange (NMHIX) to broaden the Exchange’s authority to dictate which plans are sold through the Exchange …
HB 107 – New Mexico
Introduced: 2021 Status: Inactive / Dead
Mail-Order Pharmacy Insurance Parity: House Bill 107 applies to each of the types of health insurance offered in New Mexico the same new requirement, repeated in each of the five sections of the bill, with …
HB 107 – New Mexico
Introduced: 2020 Status: Inactive / Dead
Podiatric Services Cost Sharing Limits.
HB 108 – New Mexico
Introduced: 2019 Status: Inactive / Dead
COUNTY HOSPITAL EXPENDITURE REPORTING: A county with a county hospital operated and maintained pursuant to a lease or operating agreement with a state educational institution named in Article 12, Section 11 of the constitution of …
HB 112 – New Mexico
Introduced: 2021 Status: Enacted
Health Benefits For Certain Non-citizens: An Act relating to health; requiring provision of health-related benefits and service for indigent patients regardless of immigration status. House Bill 112 requires hospitals providing indigent care (county hospitals and …
N.M. Stat. § 59A-23B-11. Rules and regulations: Minimum Healthcare Protection Act – New Mexico
Introduced: Status: Enacted
The superintendent of insurance shall, after notice and hearing, promulgate reasonable rules and regulations to define minimum benefit requirements, form requirements, rating standards and other provisions as are necessary or proper to carry out the …
Download
N.M. Stat. § 59A-23B-12. Employer utilization and loss data availability: Minimum Healthcare Protection Act – New Mexico
Introduced: Status: Enacted
Requires employer claims information to be made available upon request of and to employer of employees with such coverage.
Download
N.M. Stat. § 59A-23B-2. Purpose: Minimum Healthcare Protection Act – New Mexico
Introduced: Status: Enacted
The Minimum Healthcare Protection Act is intended to address limitations in access to healthcare by authorizing health insurers, fraternal benefit societies, health maintenance organizations and nonprofit healthcare plans to offer minimum healthcare services, policies or …
Download
N.M. Stat. § 59A-23B-3. Policy or plan; definition; criteria: Minimum Healthcare Protection Act – New Mexico
Introduced: Status: Enacted
For purposes of the Minimum Healthcare Protection Act, “policy or plan“ means a healthcare benefit policy or healthcare benefit plan that the insurer, fraternal benefit society, health maintenance organization or nonprofit healthcare plan chooses to …
Download
N.M. Stat. § 59A-23B-4. Mandated and option offering of policy or plan; exemption from certain requirements: Minimum Healthcare Protection Act – New Mexico
Introduced: Status: Enacted
Every insurer, fraternal benefit society, health maintenance organization or nonprofit healthcare plan that provides primary health insurance or healthcare coverage that insures or covers major medical expenses to more than twenty-five thousand persons within the …
Download
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.
STATE LEGISLATURE
The New Mexico Legislature convenes on the third Tuesday in January of each year. The Legislature holds 60- day sessions in odd-numbered years and 30-day sessions in even- numbered years. A Senate term is four years, for the House it is two. The state has 42 Senators and 70 Representatives. New Mexico does not pay its legislators a base salary, only a per diem. Bills do not carry over from year to year.