Requirement for mental health benefits in an individual or group health plan, or group health insurance offered in connection with the plan, for a plan year of an employer.

  1. Law
  2. New Mexico Statutes
  3. Insurance Code
  4. Health Insurance Portability
  5. Requirement for mental health benefits in an individual or group health plan, or group health insurance offered in connection with the plan, for a plan year of an employer.

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A. A group health plan or group or individual health insurance shall not impose treatment limitations or financial restrictions, limitations or requirements on the provision of mental health benefits that are more restrictive than the predominant restrictions, limitations or requirements that are imposed on coverage of benefits for other conditions.

B. A group health plan or group or individual health insurance offered in connection with that plan, may:

(1) require pre-admission screening prior to the authorization of mental health benefits whether inpatient or outpatient; or

(2) apply limitations that restrict mental health benefits provided under the plan to those that are medically necessary.

C. As used in this section, "mental health benefits" means mental health benefits as described in the group health plan, or group health insurance offered in connection with the plan; but does not include benefits with respect to treatment of substance abuse, chemical dependency or gambling addiction.

History: 1978 Comp., § 59A-23E-18, enacted by Laws 2000, ch. 6, § 1; 2019, ch. 259, § 16.

ANNOTATIONS

Repeals and reenactments. — Laws 2000, ch. 6, § 1 repeals 59A-23E-18 NMSA 1978, as enacted by Laws 1998, ch. 41, § 22, relating to individual health insurance coverage; guaranteed renewability; exceptions, and enacts the above section, effective May 17, 2000. For provisions of former section, see 1999 Cumulative Supplement.

The 2019 amendment, effective June 14, 2019, provided that a group health plan may not impose restrictions, limitations or requirements on the provisions of mental health benefits that are more restrictive than the predominant restrictions, limitations or requirements that are imposed on coverage of benefits for other conditions, and removed language that limits the annual premium increase based on providing mental health coverage parity; in Subsection A, after "group or individual health insurance", deleted "offered in connection with that plan, shall provide both medical and surgical benefits and mental health benefits. The plan", after "financial", added "restrictions, limitations", after "mental health benefits", deleted "if identical" and added "that are more restrictive than the predominant restrictions"; and deleted former Subsections C through E and redesignated former Subsection F as Subsection C.


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