N.M. Stat. § 59A-22-57
Behavioral health services; elimination of cost sharing.
A. An individual or group health insurance policy, health care plan or certificate of
health insurance that is delivered, issued for delivery or renewed in this state that offers
coverage of behavioral health services shall not impose cost sharing on those
behavioral health services.
B. For the purposes of this section:
(1)
"behavioral health services" means professional and ancillary services for
the treatment, habilitation, prevention and identification of mental illnesses, substance
abuse disorders and trauma spectrum disorders, including inpatient, detoxification,
residential treatment and partial hospitalization, intensive outpatient therapy, outpatient
therapy and all medications, including brand-name pharmacy drugs when generics are
unavailable;
(2)
"coinsurance" means a cost-sharing method that requires the insured to
pay a stated percentage of medical expenses after any deductible amount is paid;
provided that coinsurance rates may differ for different types of services under the same
individual or group health insurance policy, health care plan or certificate of health
insurance;
(3)
"copayment" means a cost-sharing method that requires the insured to
pay a fixed dollar amount when health care services are received, with the insurer
paying the balance of the allowable amount; provided that there may be different
copayment requirements for different types of services under the same individual or
group health insurance policy, health care plan or certificate of health insurance; and
(4)
"cost sharing" means a copayment, coinsurance, deductible or any other
form of financial obligation of the insured other than a premium or a share of a premium,
or any combination of any of these financial obligations, as defined by the terms of an
individual or group health insurance policy, health care plan or certificate of health
insurance.
C. The provisions of this section do not apply to excepted benefit plans as provided
under the Short-Term Health Plan and Excepted Benefit Act [Chapter 59A, Article 23G
NMSA 1978], catastrophic plans as defined under 42 USCA Section 18022(e) or high-
deductible health plans with health savings accounts until an insured's deductible has
been met, unless otherwise permitted by federal law.