N.M. Stat. § 59A-46-34
Prohibited practices.
A. No health maintenance organization, or representative thereof, may cause or
knowingly permit the use of advertising which is untrue or misleading, solicitation which
is untrue or misleading, or any form of evidence of coverage which is deceptive. For
purposes of this article:
(1)
a statement or item of information is deemed to be untrue if it does not
conform to fact in any respect which is or may be significant to an enrollee of, or person
considering enrollment in a health maintenance organization;
(2)
a statement or item of information is deemed to be misleading, whether or
not it may be literally untrue, if, in the total context in which such statement is made or
such item of information is communicated, such statement or item of information may be
reasonably understood by a reasonable person, not possessing special knowledge
regarding health care coverage, as indicating any benefit or advantage or the absence
of any exclusion, limitation or disadvantage of possible significance to an enrollee of, or
person considering enrollment in, a health maintenance organization, if such benefit or
advantage or absence of limitation, exclusion, or disadvantage does not in fact exist;
and
(3)
an evidence of coverage is deemed to be deceptive if the evidence of
coverage taken as a whole, and with consideration given to typography and format, as
well as language, shall be such as to cause a reasonable person, not possessing
special knowledge regarding health care coverage and evidences of coverage therefor,
to expect benefits, services, charges, or other advantages which the evidence of
coverage does not provide or which the health maintenance organization issuing such
evidence of coverage does not regularly make available for enrollees covered under
such evidence of coverage.
B. An enrollee may not be canceled or nonrenewed on the basis of the status of his
health.
C. No health maintenance organization, unless licensed as an insurer, may use in
its name, contracts or literature any of the words "insurance," "casualty," "surety,"
"mutual" or any other words descriptive of the insurance, casualty or surety business if
such words are used in a manner to imply that such coverages are being illegally
offered by the health maintenance organization or if deceptively similar to the name or
description of any insurance or surety corporation doing business in the state.
D. Any person not in possession of a valid certificate of authority issued pursuant to
this article shall not use the phrase "health maintenance organization" or "HMO" in the
course of operation.