Analysis

Synopsis:

 SB 317 relates to health coverage by prohibiting imposition of cost sharing for behavioral health services under certain insurance coverage policies or plans and allowing plans to exempt from regulation under the New Mexico Insurance Cove to eliminate cost sharing for behavioral health services, and establishing reporting requirements. 

Analysis:

 SB 317 makes modifications to the Health Care Purchasing Act by eliminating certain cost sharing requirements for behavioral health services.
Until January 1, 2027 cost sharing is eliminated for group health and self-insurance plans offered issued or renewed under the Health Care Purchasing Act. This would mean co-insurance, deductible or co-pay and any other form of financial obligation are prohibited. 
SB 317 defines 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 and all medications, including brand-name pharmacy drugs when generics are unavailable.
This prohibition also applies to group health insurance policies, a group or blanket health insurance policy, and individual or group health maintenance organization contract.
The Office of Superintendent of Insurance shall report by November 1 of each year to the Governor, the Legislative Finance Committee and the Interim Legislative Health and Human Services Committee data regarding the elimination of cost sharing pursuant to the provisions of this 2021 Act, including the effects on providers and patients with regard to costs for behavioral health services and the effects on health and social outcomes for patients, by using a set of performance measurement tools related to health care quality assurance, developed by a nationally recognized organization
The Legislative Finance Committee shall report by November 1 of each year to the Governor and the Interim Legislative Health and Human Services Committee data regarding the elimination of cost sharing pursuant to the provisions of this 2021 Act, including the effects on providers and patients with regard to costs for behavioral health services and the effects on health and social outcomes for patients, by using a set of performance measurement tools related to health care quality assurance, developed by a nationally recognized organization.

The effective date of the provisions of this Act is January 1, 2022

Roadrunner Capitol Reports - Legislative Tracking and Reporting Service.
www.roadrunnercapitol.com