HOUSE BILL 42
54th legislature - STATE OF NEW MEXICO - second session, 2020
INTRODUCED BY
Deborah A. Armstrong
FOR THE LEGISLATIVE HEALTH AND HUMAN SERVICES COMMITTEE
AN ACT
RELATING TO HEALTH COVERAGE; ENACTING SECTIONS OF THE GROUP BENEFITS ACT, THE PUBLIC ASSISTANCE ACT, THE NEW MEXICO INSURANCE CODE, THE HEALTH MAINTENANCE ORGANIZATION LAW AND THE NONPROFIT HEALTH CARE PLAN LAW TO ESTABLISH REIMBURSEMENT PARITY BETWEEN CERTIFIED PHARMACISTS CLINICIANS, CERTAIN PHARMACISTS AND CERTAIN OTHER LICENSED HEALTH PROFESSIONALS FOR THE SAME CLINICAL SERVICES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
SECTION 1. A new section of the Group Benefits Act is enacted to read:
"[NEW MATERIAL] PHARMACIST PRESCRIPTIVE AUTHORITY SERVICES--REIMBURSEMENT PARITY.--A group health plan shall not discriminate with respect to reimbursement under the group health plan against a certified pharmacist clinician or pharmacist certified to provide a prescriptive authority service who is acting within the scope of certification. The group health plan shall reimburse a certified pharmacist clinician or pharmacist certified to provide a prescriptive authority service who provides a service at the same rate that the group health plan reimburses, for the same service under that group health plan, any licensed physician or physician assistant licensed pursuant to the Medical Practice Act or the Osteopathic Medicine Act or any advanced practice certified nurse practitioner licensed pursuant to the Nursing Practice Act."
SECTION 2. A new section of the Public Assistance Act is enacted to read:
"[NEW MATERIAL] PHARMACIST PRESCRIPTIVE AUTHORITY SERVICES--REIMBURSEMENT PARITY.--The department shall ensure that any medical assistance program or contractor providing services to the medical assistance program does not discriminate with respect to reimbursement under the medical assistance program against a certified pharmacist clinician or pharmacist certified to provide a prescriptive authority service who is acting within the scope of certification. The medical assistance program or its contractor shall reimburse a certified pharmacist clinician or pharmacist certified to provide a prescriptive authority service who provides a service at the same rate that the medical assistance program reimburses, for the same service under that program, any licensed physician or physician assistant licensed pursuant to the Medical Practice Act or the Osteopathic Medicine Act or any advanced practice certified nurse practitioner licensed pursuant to the Nursing Practice Act."
SECTION 3. A new section of Chapter 59A, Article 22 NMSA 1978 is enacted to read:
"[NEW MATERIAL] PHARMACIST PRESCRIPTIVE AUTHORITY SERVICES--REIMBURSEMENT PARITY.--An insurer shall not discriminate with respect to reimbursement pursuant to an individual health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state against a certified pharmacist clinician or pharmacist certified to provide a prescriptive authority service who is acting within the scope of certification. The insurer shall reimburse a certified pharmacist clinician or pharmacist certified to provide a prescriptive authority service who provides a service pursuant to a health insurance plan, policy or certificate of health insurance at the same rate that the health insurance policy, health care plan or certificate of health insurance reimburses, for the same service pursuant to that policy, plan or certificate, any licensed physician or physician assistant licensed pursuant to the Medical Practice Act or the Osteopathic Medicine Act or any advanced practice certified nurse practitioner licensed pursuant to the Nursing Practice Act."
SECTION 4. A new section of Chapter 59A, Article 23 NMSA 1978 is enacted to read:
"[NEW MATERIAL] PHARMACIST PRESCRIPTIVE AUTHORITY SERVICES--REIMBURSEMENT PARITY.--An insurer shall not discriminate with respect to reimbursement pursuant to a group or blanket health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state against a certified pharmacist clinician or pharmacist certified to provide a prescriptive authority service who is acting within the scope of certification. The insurer shall reimburse a certified pharmacist clinician or pharmacist certified to provide a prescriptive authority service who provides a service pursuant to a health insurance plan, policy or certificate of health insurance at the same rate that the health insurance policy, health care plan or certificate of health insurance reimburses, for the same service pursuant to that policy, plan or certificate, any licensed physician or physician assistant licensed pursuant to the Medical Practice Act or the Osteopathic Medicine Act or any advanced practice certified nurse practitioner licensed pursuant to the Nursing Practice Act."
SECTION 5. A new section of the Health Maintenance Organization Law is enacted to read:
"[NEW MATERIAL] PHARMACIST PRESCRIPTIVE AUTHORITY SERVICES--REIMBURSEMENT PARITY.--A carrier shall not discriminate with respect to reimbursement pursuant to an individual or group health maintenance organization contract that is delivered, issued for delivery or renewed in this state against a certified pharmacist clinician or pharmacist certified to provide a prescriptive authority service who is acting within the scope of certification. The carrier shall reimburse a certified pharmacist clinician or pharmacist certified to provide a prescriptive authority service who provides a service pursuant to an individual or group contract at the same rate that the carrier reimburses, for the same service under that individual or group contract, any licensed physician or physician assistant licensed pursuant to the Medical Practice Act or the Osteopathic Medicine Act or any advanced practice certified nurse practitioner licensed pursuant to the Nursing Practice Act."
SECTION 6. A new section of the Nonprofit Health Care Plan Law is enacted to read:
"[NEW MATERIAL] PHARMACIST PRESCRIPTIVE AUTHORITY SERVICES--REIMBURSEMENT PARITY.--A health care plan shall not discriminate with respect to reimbursement pursuant to a subscriber contract that is delivered, issued for delivery or renewed in this state against a certified pharmacist clinician or pharmacist certified to provide a prescriptive authority service who is acting within the scope of certification. The health care plan shall reimburse a certified pharmacist clinician or pharmacist certified to provide a prescriptive authority service who provides a service pursuant to a subscriber at the same rate that the carrier reimburses, for the same service under that subscriber contract, any licensed physician or physician assistant licensed pursuant to the Medical Practice Act or the Osteopathic Medicine Act or any advanced practice certified nurse practitioner licensed pursuant to the Nursing Practice Act."
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