NEW MEXICO

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.

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© 2018- The SLIHCQ DatabaseInitial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

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© 2018- The SLIHCQ DatabaseInitial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.
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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