N.M. Stat. § 59A-54-13
Benefits.
A. The health insurance policy issued by the pool shall pay for medically necessary
eligible health care services rendered or furnished for the diagnoses or treatment of
illness or injury that exceed the deductible and coinsurance amounts applicable under
Section 59A-54-14 NMSA 1978 and are not otherwise limited or excluded. Eligible
expenses are the charges for the health care services and items for which benefits are
extended under the pool policy. The coverage to be issued by the pool and its schedule
of benefits, exclusions and other limitations shall be established by the board and shall,
at a minimum, reflect the levels of health insurance coverage generally available in New
Mexico for small group policies; provided that a health insurance policy issued by the
pool shall not include a lifetime maximum benefit. The superintendent shall approve the
benefit package developed by the board to ensure its compliance with the Medical
Insurance Pool Act. The benefit package shall include therapy services and hearing
aids.
B. The Medical Insurance Pool Act shall not be construed to prohibit the pool from
issuing additional types of health insurance policies with different types of benefits that,
in the opinion of the board, may be of benefit to the citizens of New Mexico.
C. The board may design and employ cost containment measures and
requirements, including preadmission certification and concurrent inpatient review, for
the purpose of making the pool more cost effective.