N.M. Stat. § 59A-47-35
Alcohol dependency coverage.
A. Each health care plan that delivers or issues for delivery in this state a group
contract providing for health care expense payments on a service benefit basis or an
indemnity benefit basis or both shall offer and make available benefits for the necessary
care and treatment of alcohol dependency. Such benefits shall:
(1)
be subject to annual deductibles and coinsurance consistent with those
imposed on other benefits within the same contract;
(2)
provide no less than thirty days necessary care and treatment in an
alcohol dependency treatment center and thirty outpatient visits for alcohol dependency
treatment; and
(3)
be offered for benefit periods of no more than one year and may be limited
to a lifetime maximum of no less than two benefit periods.
Such offer of benefits shall be subject to the rights of the group contract holder to
reject the coverage or to select any alternative level of benefits if that right is offered by
or negotiated with that health care plan.
B. For purposes of this section, "alcohol dependency treatment center" means a
facility that contracts with the health care plan and that provides a program for the
treatment of alcohol dependency pursuant to a written treatment plan approved and
monitored by a physician or meeting the quality standards of the department of health
and which facility also:
(1)
is affiliated with a hospital under a contractual agreement with an
established system for patient referral;
(2)
is accredited as such a facility by the joint commission on accreditation of
hospitals; or
(3)
meets at least the minimum standards adopted by the department of
health.
C. This section applies to contracts delivered or issued for delivery or renewed,
extended or amended in this state on or after July 1, 1983 or upon expiration of a
collective bargaining agreement applicable to a particular contract holder, whichever is
later; provided that this section does not apply to blanket, short-term travel, accident-
only, limited or specified disease, individual conversion contracts or contracts designed
for issuance to persons eligible for coverage under Title 18 of the Social Security Act,
known as medicare, or any other similar coverage under state or federal governmental
plans. With respect to any contract forms approved by the insurance division prior to the
effective date of this section, an insurer is authorized to comply with this section by the
use of endorsements or riders, provided such endorsements or riders are approved by
the insurance division as being in compliance with this section and applicable provisions
of the Insurance Code.
D. If an organization offering group health benefits to its members makes more than
one health care plan or health insurance plan policy available to its members on a
member option basis, the organization shall not require alcohol dependency coverage
from one health care plan or health insurer without requiring the same level of alcohol
dependency coverage for all other health care plans or health insurance policies that
the organization makes available to its members.