PROHIBITION ON COST-SHARING FOR TESTING AND HEALTH CARE SERVICES RELATED TO MONKEYPOX

STATE OF NEW MEXICO OFFICE OF SUPERINTENDENT OF INSURANCE SUPERINTENDENT OF INSURANCE Russell Toal DEPUTY SUPERINTENDENT Jennifer A. Catechis Main Office: 1120 Paseo de Peralta, Room 428, Santa Fe, NM 87501 Satellite Office: 6200 Uptown Blvd NE, Suite 400, Albuquerque, NM 87110 Main Phone: (505) 827-4601 | Satellite Phone: (505) 322-2186 | Toll Free: (855) 4 - ASK - OSI www.osi.state.nm.us BULLETIN 2022-017 SEPTEMBER 23, 2022 TO: ALL HEALTH INSURANCE PLANS OFFERING MAJOR MEDICAL COVERAGE IN NEW MEXICO RE: PROHIBITION ON COST-SHARING FOR TESTING AND HEALTH CARE SERVICES RELATED TO MONKEYPOX On August 4, 2022, the U.S. Department of Health and Human Services declared the monkeypox virus a public health emergency. Please see, https://www.hhs.gov/about/news/ 2022/08/04/biden-harris-administration-bolsters-monkeypox-response-hhs-secretary-becerradeclares-public-health-emergency.html. Section 13.10.13.12 NMAC prohibits cost-sharing requirements related to testing or delivery of health care for any condition that is the subject of a declared public health emergency. No individuals shall be charged cost-sharing (coinsurance, deductible, or copayments) for testing or treatment related to monkeypox that is received during the declared the public health emergency. Health plans and health insurance issuers shall reimburse any individuals who were erroneously charged cost-sharing for monkeypox since August 4, 2022. On-going violations of Section 13.10.13.12 NMAC shall be subject to enforcement actions to remedy those violations which include, but are not limited to, administrative penalties of up to $10,000 per violation, and suspension of any certificate of authority or license issued under the insurance code. To report a violation of this provision, file a complaint with OSI’s Managed Health Care Bureau at https://www.osi.state.nm.us/pages/misc/mhcb-complaint or call 855-427-5674. B U L L E T I N 2 0 2 2 - 0 1 7 P a g e | 2 Main Office: 1120 Paseo de Peralta, Room 428, Santa Fe, NM 87501 Satellite Office: 6200 Uptown Blvd NE, Suite 400, Albuquerque, NM 87110 Main Phone: (505) 827-4601 | Satellite Phone: (505) 322-2186 | Toll Free: (855) 4 - ASK - OSI www.osi.state.nm.us Monkeypox vaccines are available. Individuals interested in getting a vaccine can register at monkeypoxnm.org for a confidential consultation to see if the vaccine is recommended for them. For general information about monkeypox, go to www.nmhealth.org/about/phd/idb/mpv/. Please direct any questions concerning this guidance to cass.brulotte@state.nm.us. ISSUED this 23rd day of September, 2022. __________________________________ RUSSELL TOAL Superintendent of Insurance