0001| SENATE BILL 1240 | 0002| 43rd legislature - STATE OF NEW MEXICO - first session, 1997 | 0003| INTRODUCED BY | 0004| MANNY M. ARAGON | 0005| | 0006| | 0007| | 0008| | 0009| | 0010| AN ACT | 0011| RELATING TO HEALTH CARE; ENACTING THE HEALTH CARE ACT TO | 0012| PROVIDE FOR COMPREHENSIVE STATEWIDE HEALTH CARE, PLANNING AND | 0013| COST SAVINGS; CREATING A COMMISSION; PROVIDING ITS POWERS AND | 0014| DUTIES; PROVIDING FOR TRANSFERS; MAKING AN APPROPRIATION. | 0015| | 0016| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO: | 0017| Section 1. SHORT TITLE.--This act may be cited as the | 0018| "Health Care Act" | 0019| Section 2. PURPOSE OF ACT.--The purpose of the Health | 0020| Care Act is to create a publicly financed statewide health | 0021| program to provide coverage for health care services for all | 0022| state residents and to control escalating health care costs. | 0023| Section 3. DEFINITIONS.--As used in the Health Care Act: | 0024| A. "capital budget" means that portion of a health | 0025| care facility's global budget that applies to real property and | 0001| tangible personal property, including buildings, machinery and | 0002| equipment and transportation equipment; | 0003| B. "capitation" means a set fee for providing | 0004| specified health care services for all members of an enrolled | 0005| group; | 0006| C. "commission" means the health care commission | 0007| created pursuant to the Health Care Act; | 0008| D. "director" means the director of the commission; | 0009| E. "eligible person" means: | 0010| (1) except as provided in Paragraphs (2) | 0011| through (7) of this subsection, a person who has resided in the | 0012| state for at least one year and any child of that person who | 0013| lives with the person and is in the legal custody of the | 0014| person; | 0015| (2) a public employee, including an employee | 0016| of the state or any political subdivision of the state and an | 0017| employee of a public school or state educational institution; | 0018| (3) a medicaid or medicare recipient as | 0019| participation is authorized by federal statute, regulation, | 0020| waiver or agreement; | 0021| (4) a person entitled to health care services | 0022| through the veterans' administration as participation is | 0023| authorized by federal statute, regulation, waiver or agreement; | 0024| (5) a person, except federal retirees covered | 0025| by other federal health insurance plans as participation is | 0001| authorized by federal statute, regulation, waiver or agreement; | 0002| (6) a person covered by a health insurance | 0003| plan pursuant to the provisions of the federal Employee | 0004| Retirement Income Security Act of 1974 as participation is | 0005| authorized by federal statute, regulation, waiver or agreement | 0006| or as a business covered by the provisions of that act chooses | 0007| to be covered under the provisions of the health care plan; or | 0008| (7) a person becoming eligible by paymnt of a | 0009| premium pursuant to Section 17 of the Health Care Act, | 0010| F. "global budget" means the prospective operating | 0011| budget of a health care facility, excluding the capital budget; | 0012| G. "group practice" means a health maintenance | 0013| organization or other association of health care providers that | 0014| provides one or more specialized health care services, such as | 0015| laboratory services, x-Ray services, emergency care and | 0016| inpatient or outpatient hospital services; | 0017| H. "health care facility" means a clinic, general | 0018| or special hospital, outpatient facility, psychiatric hospital, | 0019| laboratory, skilled nursing facility or nursing facility. For | 0020| the purpose of determining global budgets, "health care | 0021| facility" includes a group practice or transportation service; | 0022| I. "health care provider" means: | 0023| (1) a person licensed or certified in New | 0024| Mexico as a: | 0025| (a) physician; | 0001| (b) osteopathic physician; | 0002| (c) physician assistant or osteopathic | 0003| physician's assistant; | 0004| (d) chiropractic physician; | 0005| (e) dentist; | 0006| (f) psychologist, social worker; | 0007| professional clinical mental health counselor, professional | 0008| mental health counselor, marriage and family therapist or | 0009| registered mental health counselor; | 0010| (g) optometrist; | 0011| (h) podiatrist; | 0012| (I) pharmacist; | 0013| (j) pharmacist clinician; | 0014| (k) registered nurse or certified nurse | 0015| practitioner; | 0016| (l) visiting nurse service, private duty | 0017| registry or other certified home health agency; | 0018| (m) doctor of oriental medicine; | 0019| (n) physical therapist; | 0020| (o) massage therapist; | 0021| (p) occupational therapist; | 0022| (q) speech-language pathologist; | 0023| (r) audiologist; | 0024| (s) respiratory care practitioner; | 0025| (t) midwife; | 0001| (u) dietician or nutritionist; | 0002| (v) transportation service; or | 0003| (w) other practitioner of the healing | 0004| arts designated as a health care provider by the commission; | 0005| (2) a person licensed or certified by a | 0006| nationally recognized professional organization and designated | 0007| as a health care provider by the commission as a: | 0008| (a) prosthetist; | 0009| (b) orthotist; or | 0010| (c) oculist; or | 0011| (3) a group practice or transportation service | 0012| for that portion of the group practice or transportation | 0013| service that is paid pursuant to a fee schedule established by | 0014| the commission; | 0015| J. "health plan" means the mechanism developed by | 0016| the commission for provision of health care services pursuant | 0017| to the Health Care Act; | 0018| K. "implicit price deflator" means a measure of | 0019| inflation that is published in the United States department of | 0020| commerce survey of current business; | 0021| L. "major capital expenditure" means the purchase | 0022| of diagnostic, treatment or transportation equipment costing | 0023| fifty thousand dollars ($50,000) or more or construction or | 0024| renovation of facilities; | 0025| M. "person" means a legal entity; | 0001| N. "primary care provider" means a licensed | 0002| physician, osteopathic physician, nurse practitioner, | 0003| physician's assistant, osteopathic physician's assistant, | 0004| pharmacist clinician or other provider certified by the | 0005| commission as a primary care provider who provides the first | 0006| level of health care for an eligible person's health needs, as | 0007| specified by the commission; | 0008| O. "provider budget" means the fee schedule | 0009| established by the commission each year to pay for health care | 0010| services provided by health care providers participating in the | 0011| health plan; and | 0012| P. "transportation service" means ambulance, | 0013| helicopter or other transport that is equipped with emergency | 0014| supplies and equipment and is used to transport patients to | 0015| health care providers or facilities and other transportation | 0016| authorized by the commission. | 0017| Section 4. HEALTH CARE COMMISSION CREATED--VOTING AND | 0018| NONVOTING MEMBERS.-- | 0019| A. The "health care commission" is created as an | 0020| adjunct agency pursuant to the Executive Reorganization Act. | 0021| The general services department, the department of health and | 0022| the human services department shall cooperate with the | 0023| commission and assist it as needed. The commission consists of | 0024| fifteen voting members and nine nonvoting members. The voting | 0025| members, all of whom shall be appointed by the governor with | 0001| the advice and consent of the senate, are: | 0002| (1) four persons who represent consumer | 0003| interests, at least one of whom represents elderly consumer | 0004| interests and at least one of whom represents Native American | 0005| interests; | 0006| (2) two persons who represent persons with | 0007| physical or mental impairments that limit one or more of their | 0008| major life activities; | 0009| (3) five persons who represent either health | 0010| care providers or health care facilities; | 0011| (4) two persons who represent business | 0012| ownership interests, with one person representing employers of | 0013| more than fifteen persons and one person representing employers | 0014| of fifteen persons or fewer; and | 0015| (5) two persons who represent organized labor. | 0016| B. The voting members appointed shall reflect the | 0017| ethnic, gender, economic and geographic diversity of the state. | 0018| To ensure fair geographic representation of all areas of the | 0019| state, members shall be appointed from each of the state board | 0020| of education districts established by the 1991 Educational | 0021| Redistricting Act as follows: | 0022| (1) two from state board of education district | 0023| 1; | 0024| (2) one from state board of education district | 0025| 2; | 0001| (3) one from state board of education district | 0002| 3; | 0003| (4) two from state board of education district | 0004| 4; | 0005| (5) two from state board of education district | 0006| 5; | 0007| (6) one from state board of education district | 0008| 6; | 0009| (7) two from state board of education district | 0010| 7; | 0011| (8) two from state board of education district | 0012| 8; | 0013| (9) one from state board of education district | 0014| 9; and | 0015| (10) one from state board of education | 0016| district 10. | 0017| C. The initial voting members of the commission | 0018| shall be appointed by the governor by August 1, 1997. The | 0019| terms of the initial voting members appointed shall be | 0020| staggered as follows: five members shall be appointed for a | 0021| term of four years; five members shall be appointed for a term | 0022| of three years; and five members shall be appointed for a term | 0023| of two years. Thereafter, all members shall be appointed for | 0024| terms of four years. After initial terms are served, no member | 0025| shall serve more than two consecutive four-year terms. | 0001| D. A voting member may be removed from the | 0002| commission only for incompetence, neglect of duty or | 0003| malfeasance in office. The governor shall initiate removal | 0004| proceedings. No voting member shall be removed without having | 0005| first been given notice of hearing and an opportunity to be | 0006| heard. The supreme court has exclusive original jurisdiction | 0007| over proceedings to remove a voting member. The supreme | 0008| court's decision on removal shall be final. | 0009| E. A majority of the commission's voting members | 0010| constitutes a quorum for the transaction of business. The | 0011| commission shall choose annually its chairman and any other | 0012| officers it deems necessary. | 0013| F. Voting members shall receive per diem and | 0014| mileage in accordance with the provisions of the Per Diem and | 0015| Mileage Act. | 0016| G. The commission is composed of the following nine | 0017| nonvoting members: | 0018| (1) the secretary of health; | 0019| (2) the secretary of human services; | 0020| (3) the secretary of children, youth and | 0021| families; | 0022| (4) the secretary of taxation and revenue; | 0023| (5) a person designated by the New Mexico | 0024| office of Indian affairs, after consultation with the federal | 0025| Indian health services; | 0001| (6) two members of the house of | 0002| representatives appointed by the speaker of the house, | 0003| including one member of the majority party and one member of | 0004| the minority party; and | 0005| (7) two members of the senate, including one | 0006| member of the majority party and one member of the minority | 0007| party appointed by the committees' committee of the senate, or, | 0008| if the senate appointments are made in the interim, by the | 0009| president pro tempore of the senate after consultation with and | 0010| agreement of a majority of the members of the committees' | 0011| committee. | 0012| H. The governor shall recommend to the legislature | 0013| by January 1, 1998 the need for compensation for commission | 0014| members. | 0015| Section 5. CONFLICT OF INTEREST.-- | 0016| A. Except for nonvoting members and members | 0017| appointed to represent health care facilities or health care | 0018| providers, no commission member or a member of his immediate | 0019| family shall have any financial interest, direct or indirect, | 0020| in a person providing health care services or health care | 0021| insurance. | 0022| B. The commission shall adopt a conflict of | 0023| interest disclosure statement for use by all members that | 0024| specifies financial interests of the member or member of his | 0025| immediate family in a person providing the health care services | 0001| or health care insurance. | 0002| C. No member of the commission shall vote on any | 0003| matter in which he or a member of his immediate family has a | 0004| financial interest. | 0005| D. If there is a question about a conflict of | 0006| interest of a member, the commission shall vote on whether to | 0007| allow the member to vote. | 0008| Section 6. DIRECTOR--STAFF--CONTRACTS--BUDGETS.-- | 0009| A. To assist in carrying out its duties, the | 0010| commission shall appoint and set the salary of a "director". | 0011| The director shall serve at the pleasure of the commission. | 0012| B. The director may employ those persons necessary | 0013| to carry out the purposes of the Health Care Act. Employees | 0014| are subject to the provisions of the Personnel Act. | 0015| C. The director and his staff shall implement the | 0016| Health Care Act in accordance with that act and the policies | 0017| and regulations adopted by the commission. | 0018| D. If the director determines that commission staff | 0019| or another state agency does not have the resources or | 0020| expertise to perform a necessary task, the commission may | 0021| contract with a person that has a demonstrated capability to | 0022| perform the task. If claims processing is provided by | 0023| contract, that contract shall require that all work shall be | 0024| performed entirely in New Mexico. All contracts shall be | 0025| reviewed at least every two years to ensure that they continue | 0001| to meet the criteria and performance standards of the contract | 0002| and the needs of the commission. | 0003| E. The director may contract with consultants that | 0004| the director deems necessary to advise him or the commission in | 0005| carrying out the provisions of the Health Care Act. | 0006| F. The director shall prepare an annual budget and | 0007| plan of operation for the commission. He shall submit both to | 0008| the commission for its approval before implementation. | 0009| Section 7. COMMISSION--GENERAL POWERS AND DUTIES.--The | 0010| commission shall: | 0011| A. adopt a five-year program of operation to | 0012| implement the provisions of the Health Care Act; | 0013| B. provide a program to educate the public, health | 0014| care providers and health care facilities about the health care | 0015| plan and the persons eligible to receive its benefits; | 0016| C. study and adopt the most cost-effective methods | 0017| of providing health care services to all eligible persons, | 0018| according high priority to increased reliance on: | 0019| (1) preventive and primary care, including | 0020| immunization and screening examinations; | 0021| (2) providing health care services in rural or | 0022| underserved areas of the state; | 0023| (3) in-home and community-based alternatives | 0024| to institutional care; and | 0025| (4) case management services when appropriate; | 0001| D. establish fee schedules and other compensation | 0002| for health care providers and adopt standards and procedures | 0003| for negotiating and entering into contracts with participating | 0004| health care providers; | 0005| E. establish global budgets for health care | 0006| facilities and adopt: | 0007| (1) standards and procedures for determining | 0008| base budgets and annual global budgets for health care | 0009| facilities; and | 0010| (2) a capital expenditure program that | 0011| requires prior approval for major capital expenditures by | 0012| health care facilities; | 0013| F. negotiate and enter into health care reciprocity | 0014| agreements with other states and foreign countries and | 0015| negotiate and enter into health care agreements with out-of- | 0016| state health care providers and health care facilities; | 0017| G. develop a payment system for health care | 0018| providers and health care facilities that affords continuity of | 0019| payments; | 0020| H. collect and analyze health care data and other | 0021| data necessary to improve the efficiency and effectiveness of | 0022| health care services and to control costs of health care | 0023| services in New Mexico, and shall include data on: | 0024| (1) mortality and natality, including | 0025| accidental causes of death; | 0001| (2) morbidity; | 0002| (3) health behavior; | 0003| (4) disability; | 0004| (5) health care services system costs, | 0005| availability, utilization and revenues; | 0006| (6) environmental factors; | 0007| (7) availability, adequacy and training of | 0008| health care services personnel; | 0009| (8) demographic factors; | 0010| (9) social and economic conditions affecting | 0011| health; and | 0012| (10) other factors determined by the | 0013| commission; | 0014| I. standardize data collection and specific methods | 0015| of measurement across databases and use scientific sampling or | 0016| complete enumeration for reporting health information; | 0017| J. establish a health care delivery system that is | 0018| efficient to administer and that eliminates unnecessary | 0019| administrative costs; | 0020| K. adopt rules and regulations necessary to | 0021| implement and monitor a state formulary to provide prescription | 0022| drugs, medicine, durable medical equipment and supplies, | 0023| eyeglasses, hearing aids, oxygen and related services; | 0024| L. study and evaluate the adequacy and quality of | 0025| health care services furnished pursuant to the Health Care Act, | 0001| the cost of each type of service and the effectiveness of cost- | 0002| containment measures in the health plan; | 0003| M. study and monitor the migration of persons to | 0004| New Mexico to determine if persons with costly health care | 0005| needs are moving to New Mexico to receive health care services. | 0006| If migration appears to threaten the financial stability of the | 0007| health plan, the commission shall recommend to the legislature | 0008| changes in eligibility requirements, premiums or other | 0009| statutory changes that may be necessary to maintain the | 0010| financial stability of the health plan; | 0011| N. study and evaluate the cost of medical | 0012| professional liability and medical professional liability | 0013| insurance and recommend statutory changes to the legislature as | 0014| necessary; | 0015| O. set or approve changes in benefit standards | 0016| covered by the health plan; | 0017| P. conduct necessary investigations and inquiries | 0018| and compel by subpoena the submission of information and | 0019| documents that the commission considers necessary to carry out | 0020| its duties; | 0021| Q. adopt rules and regulations necessary to | 0022| implement, administer and monitor the operation of the health | 0023| plan; | 0024| R. meet as needed, but no less than once every | 0025| three months; and | 0001| S. report annually to the legislature and the | 0002| governor on the commission's activities and the operation of | 0003| the health plan and include in the annual report: | 0004| (1) a summary of information about health care | 0005| needs, health care services, health care expenditures, revenues | 0006| and other relevant issues relating to the health plan and the | 0007| five-year program; and | 0008| (2) recommendations on methods to control | 0009| health care costs and improve access to and the quality of | 0010| health care for state residents, as well as recommendations for | 0011| legislative action if any are found to be necessary. | 0012| Section 8. ADVISORY BOARDS.-- | 0013| A. The commission may establish advisory boards to | 0014| assist it in performing its duties. | 0015| B. The commission shall establish a "health care | 0016| provider advisory board" to advise and assist the commission in | 0017| all decisions requiring the expertise of health care providers. | 0018| Each noncommission member shall represent a different licensed | 0019| health profession. | 0020| C. The commission may appoint commission members | 0021| and up to five additional persons to serve on each advisory | 0022| board it creates. Advisory board members who are not | 0023| commission members may be paid per diem and mileage in | 0024| accordance with the provisions of the Per Diem and Mileage Act. | 0025| D. Staff and technical assistance for the advisory | 0001| boards shall be provided by the commission as necessary. | 0002| Section 9. HEALTH CARE DELIVERY REGIONS.--The commission | 0003| shall establish health care delivery regions in the state, | 0004| based on geography and health care resources. The regions may | 0005| have differential fee schedules, global budgets, capital | 0006| allocations or other features to encourage the provision of | 0007| health care services in rural and other underserved areas. | 0008| Section 10. REGIONAL COUNCILS.-- | 0009| A. The commission shall create regional councils in | 0010| the health care delivery regions of the state. | 0011| B. The regional councils shall be composed of at | 0012| least one of the commission members who live in the region and | 0013| five other members appointed by the commission. No more than | 0014| two council members shall have any financial interest, direct | 0015| or indirect, in a person providing health care services or a | 0016| person providing health care insurance. | 0017| C. Members of a regional council may be paid per | 0018| diem and mileage in accordance with the provisions of the Per | 0019| Diem and Mileage Act. | 0020| D. The regional councils shall hold public hearings | 0021| to receive comments, suggestions and recommendations from the | 0022| public regarding regional health care needs. The councils | 0023| shall report to the commission so that regional concerns are | 0024| considered in the development and update of the five-year | 0025| program, fee schedules and global budgets. | 0001| E. Staff and technical assistance for the regional | 0002| councils shall be provided by the commission as necessary. | 0003| Section 11. COMMISSION, COUNCILS AND ADVISORY BOARDS-- | 0004| MEETINGS.--All meetings of the commission, councils and | 0005| advisory boards shall be conducted pursuant to the provisions | 0006| of the Open Meetings Act. | 0007| Section 12. RULES AND REGULATIONS.-- | 0008| A. The commission shall adopt reasonable | 0009| regulations necessary to carry out the duties of the commission | 0010| and the provisions of the Health Care Act. | 0011| B. No regulation affecting any person or agency | 0012| outside the commission shall be adopted, amended or repealed | 0013| without a public hearing on the proposed action before the | 0014| commission or a hearing officer designated by the commission. | 0015| The hearing officer may be a member of the commission's staff. | 0016| The hearing shall be held in Santa Fe unless the commission | 0017| determines that it would be in the interest of those affected | 0018| to hold the hearing elsewhere in the state. Notice of the | 0019| subject matter of the regulation, the action proposed to be | 0020| taken, the time and place of the hearing, the manner in which | 0021| interested persons may present their views and the method by | 0022| which copies of the proposed regulation, proposed amendment or | 0023| repeal of an existing regulation may be obtained shall be | 0024| published once at least thirty days prior to the hearing date | 0025| in a newspaper of general circulation and mailed at least | 0001| thirty days prior to the hearing date to all persons who have | 0002| made a written request for advance notice of hearing. | 0003| C. All rules and regulations adopted by the | 0004| commission shall be filed in accordance with the State Rules | 0005| Act. | 0006| Section 13. HEALTH PLAN.-- | 0007| A. After notice and public hearing, including | 0008| taking public comment and the reports of the regional councils, | 0009| the commission shall adopt a health plan. | 0010| B. The health plan shall be designed to provide | 0011| comprehensive, necessary and appropriate health care benefits, | 0012| including preventive health care and primary, secondary and | 0013| tertiary health care for acute and chronic conditions. The | 0014| health plan may provide for certain health care services to be | 0015| phased in as the health plan budget allows. | 0016| C. The commission shall specify the health care | 0017| services to be included as covered by the health plan and shall | 0018| include: | 0019| (1) preventive health services; | 0020| (2) provider services; | 0021| (3) inpatient and outpatient medical services; | 0022| (4) laboratory tests and imaging procedures; | 0023| (5) in-home, community-based and institutional | 0024| long-term care services; | 0025| (6) prescription drugs; | 0001| (7) inpatient and outpatient mental health | 0002| services; | 0003| (8) drug and substance abuse services; | 0004| (9) preventive and prophylactic dental | 0005| services, including an annual dental examination and cleaning, | 0006| but not including orthodontic services; | 0007| (10) vision appliances, including medically | 0008| necessary contact lenses; | 0009| (11) medical supplies, durable medical | 0010| equipment and selected assistive devices, including hearing and | 0011| speech assistance devices; and | 0012| (12) experimental treatment services as | 0013| specified on a case-by-case basis by the commission. | 0014| D. Covered services shall not include: | 0015| (1) surgery for cosmetic purposes other than | 0016| for reconstructive purposes; | 0017| (2) medical examinations and medical reports | 0018| prepared for purchasing or renewing life insurance or | 0019| participating as a plaintiff or defendant in a civil action for | 0020| the recovery or settlement of damages; and | 0021| (3) cosmetic dental services except for | 0022| reconstructive purposes. | 0023| E. The health plan shall specify the services to be | 0024| covered and the amount, scope and duration of benefits. The | 0025| plan shall include a maximum amount or percentage for | 0001| administrative costs, and this maximum may be variable in | 0002| relation to total costs of services provided under the health | 0003| plan. | 0004| F. The commission shall specify the terms and | 0005| conditions for participation of health care providers and | 0006| health care facilities in the health plan. | 0007| G. The commission shall control health care costs | 0008| so that eligible persons receive comprehensive health services, | 0009| consistent with budget constraints, including needed health | 0010| care services in rural and other underserved areas. | 0011| H. The health plan shall phase in eligible persons | 0012| as their participation becomes possible through agreements, | 0013| waivers or federal legislation. The health plan may provide | 0014| for certain preventive health care services to be offered to | 0015| all New Mexicans regardless of eligibility. | 0016| I. The five-year program shall be reviewed by the | 0017| regional councils and the commission annually and revised as | 0018| necessary. Revisions shall be adopted by the commission in | 0019| accordance with Section 12 of the Health Care Act. In | 0020| projecting services under the health plan, the commission shall | 0021| take all reasonable steps to ensure that long-term care, mental | 0022| health services and dental care are provided at the earliest | 0023| practical times consistent with budget constraints. | 0024| J. Any changes in health care services offered by | 0025| the health plan shall be approved by the commission. | 0001| Section 14. LONG-TERM CARE.-- | 0002| A. Long-term care may include: | 0003| (1) home- and community-based services, | 0004| including personal assistance and attendant care; | 0005| (2) hospice care; and | 0006| (3) institutional care. | 0007| B. No later than one year after appointment of the | 0008| director, the commission shall appoint a "long-term care | 0009| committee" made up of representatives of health care consumers, | 0010| providers and administrators to develop a plan for integrating | 0011| long-term care into the health plan. The committee shall | 0012| report its plan to the commission no later than one year from | 0013| its appointment. Committee members may receive per diem and | 0014| mileage as provided in the Per Diem and Mileage Act. | 0015| C. The long-term care component of the health plan | 0016| shall provide for service coordination, case management and | 0017| noninstitutional services where appropriate. | 0018| D. Nothing in this section affects long-term care | 0019| services paid through federal programs or private insurance. | 0020| E. Nothing in this section precludes the commission | 0021| from including long-term care services from the inception of | 0022| the health plan. | 0023| Section 15. MENTAL HEALTH SERVICES.-- | 0024| A. Mental health services may include: | 0025| (1) services for acute and chronic conditions; | 0001| (2) home- and community-based services; and | 0002| (3) institutional care. | 0003| B. No later than one year after appointment of the | 0004| director, the commission shall appoint a "mental health | 0005| services committee" made up of representatives of mental health | 0006| care consumers, providers and administrators to develop a plan | 0007| for integrating mental health services into the health plan. | 0008| The committee shall report its plan to the commission no later | 0009| than one year from its appointment. Committee members may | 0010| receive per diem and mileage as provided in the Per Diem and | 0011| Mileage Act. | 0012| C. The mental health services component of the | 0013| health plan shall provide for service coordination, case | 0014| management and noninstitutional services where appropriate. | 0015| D. Nothing in this section affects mental health | 0016| services paid through federal programs or private insurance. | 0017| E. Nothing in this section precludes the commission | 0018| from including mental health services from the inception of the | 0019| health care plan. | 0020| Section 16. MEDICAID COVERAGE--JOINT POWERS AGREEMENTS.-- | 0021| The commission may enter into joint powers agreements with the | 0022| human services department in accordance with the Joint Powers | 0023| Agreements Act for the purpose of furthering the goals of the | 0024| Health Care Act. These agreements may transfer certain | 0025| medicaid functions to the commission to allow the commission to | 0001| implement the health plan. | 0002| Section 17. HEALTH PLAN COVERAGE--ELIGIBLE PERSONS-- | 0003| NONRESIDENT STUDENTS--ELIGIBILITY CARD--PENALTIES.-- | 0004| A. An eligible person shall be covered by the | 0005| health plan, but a person who has not resided in New Mexico for | 0006| at least one year may become an eligible person upon payment of | 0007| a premium as determined by the commission. | 0008| B. State educational institutions shall purchase | 0009| coverage under the health plan for its out-of-state and | 0010| emancipated students through fees assessed to students. The | 0011| board of regents or other governing body of a state educational | 0012| institution shall set the fees at the amount determined by the | 0013| commission. | 0014| C. A student at a state educational institution who | 0015| has not resided in the state for one year may demonstrate proof | 0016| of health insurance coverage by a policy in another state that | 0017| is acceptable to the commission, and his fee shall be reduced | 0018| as provided by the commission. | 0019| D. The commission shall adopt regulations to | 0020| determine proof of a person's eligibility for the health plan | 0021| or a student's proof of nonresident insurance coverage. The | 0022| regulations shall provide a method for the purging of | 0023| eligibility when a person is no longer eligible for coverage. | 0024| E. An eligible person shall receive a card as proof | 0025| of eligibility. The card shall be electronically readable and | 0001| shall contain a picture or electronic image, information that | 0002| identifies the person for treatment and electronic billing and | 0003| payment and any other information the commission deems | 0004| necessary. | 0005| F. The eligibility card is not transferable. A | 0006| person who lends his card to another and a person who uses | 0007| another's card shall each be liable to the commission for the | 0008| full cost of the health care services provided to the user. | 0009| Each person shall pay the liability in full within ten days of | 0010| being billed. If either person does not pay his liability, the | 0011| other person shall be liable for that share. Liabilities | 0012| pursuant to this section shall be collected by the taxation and | 0013| revenue department in the same manner as delinquent taxes are | 0014| collected pursuant to the Tax Administration Act. | 0015| G. A person who lends his card to another or a | 0016| person who uses another's card a second time is guilty of a | 0017| misdemeanor and shall be sentenced pursuant to the provisions | 0018| of Section 31-19-1 NMSA 1978. A third or subsequent conviction | 0019| is a fourth degree felony and the offender shall be sentenced | 0020| pursuant to the provisions of Section 31-18-15 NMSA 1978. | 0021| Persons convicted pursuant to this subsection are also liable | 0022| for the amounts specified in Subsection F of this section. | 0023| Section 18. PRIMARY CARE PROVIDER--RIGHT TO CHOOSE-- | 0024| ACCESS TO SERVICES.-- | 0025| A. Except as provided in the Workers' Compensation | 0001| Act, an eligible person has the right to choose a primary care | 0002| provider. If an eligible person does not choose a primary care | 0003| provider, one shall be assigned by procedures pursuant to | 0004| regulations of the commission. | 0005| B. The primary care provider shall be responsible | 0006| for providing medical treatment, other than medical | 0007| emergencies. If the expertise of another health care provider | 0008| is needed, the primary care provider shall make a referral to | 0009| the appropriate specialty. Except as provided in Subsections C | 0010| and E of this section, health care provider specialists shall | 0011| be paid only if the patient has been referred by the patient's | 0012| primary care provider. | 0013| C. The commission shall by regulation specify the | 0014| conditions under which an eligible person may select a | 0015| specialist as a primary care provider. The commission shall | 0016| set primary care provider rates for specialists when serving as | 0017| primary care providers. | 0018| D. The commission shall by regulation specify how | 0019| often and under what conditions an eligible person may change | 0020| his primary care provider. | 0021| E. The commission shall by regulation specify when | 0022| and under what circumstances an eligible person may self-refer, | 0023| including self-referral to chiropractors, acupuncturists, | 0024| mental health professionals and other health care providers who | 0025| are not primary care providers. | 0001| Section 19. DISCRIMINATION PROHIBITED.--No health care | 0002| provider or health care facility shall discriminate against or | 0003| refuse to furnish health care services to a person covered by | 0004| the plan on the basis of race, color, income level, national | 0005| origin, religion, gender, sexual orientation, disabling | 0006| condition or payment status. Nothing in this section shall | 0007| require a health care provider or health care facility to care | 0008| for a patient if it is not qualified to provide the needed care | 0009| and it does not offer that needed care to the general public. | 0010| Section 20. UTILIZATION REVIEW--MONITORING--EFFICIENCY | 0011| OF OPERATIONS--PENALTIES.-- | 0012| A. The commission shall implement an evaluation and | 0013| monitoring program that considers, at a minimum, access to | 0014| care, quality of care and utilization of care provided by the | 0015| health plan, including geographic distribution of health care | 0016| resources. | 0017| B. The commission shall set standards and review | 0018| benefits to ensure that effective, cost-efficient and | 0019| appropriate health care services are rendered. | 0020| C. The commission shall establish an ongoing system | 0021| for monitoring patterns of practice and peer review. The | 0022| system shall include the appointment of an advisory group | 0023| consisting of health care providers, health care facilities and | 0024| other knowledgeable persons to advise the commission and staff | 0025| on health care practice issues. | 0001| D. The commission shall establish a system of peer | 0002| education for health care providers or health care facilities | 0003| engaging in aberrant patterns of practice. If the commission | 0004| determines that peer education efforts have failed, the | 0005| commission may refer the matter to the appropriate licensing or | 0006| certifying board. | 0007| E. The commission shall provide by regulation the | 0008| procedures for recouping payments or withholding payments for | 0009| health care services determined by the commission to be | 0010| medically unnecessary. In addition, the commission may provide | 0011| by regulation for the assessment of administrative penalties | 0012| for up to three times the amount of excess payments if it finds | 0013| that excessive billings were part of an aberrant pattern of | 0014| practice. Administrative penalties shall be deposited in the | 0015| current school fund. | 0016| F. After consultation with the peer review advisory | 0017| group, the commission may suspend or revoke a health care | 0018| provider's or health care facility's privilege to provide | 0019| health care services under the health plan for aberrant | 0020| patterns of practice, including overutilization, unnecessary | 0021| referrals, attempts to unbundle health care services or other | 0022| practices that the commission deems a violation of the Health | 0023| Care Act or regulations adopted pursuant to that act. As used | 0024| in this section, "unbundle" means to divide a service into | 0025| components in an attempt to increase or with the effect of | 0001| increasing compensation from the health plan. | 0002| G. The commission shall report a suspension or | 0003| revocation to practice under the Health Care Act to the | 0004| appropriate licensing or certifying board. | 0005| H. The commission shall report cases of suspected | 0006| fraud by a health care provider or a health care facility to | 0007| the attorney general or to the district attorney of the county | 0008| where the health care provider or health care facility operates | 0009| for investigation and prosecution. | 0010| I. The commission shall review and adopt | 0011| professional practice guidelines developed by state and | 0012| national medical and specialty organizations, the United States | 0013| agencies for health care policy and research and other | 0014| organizations as it deems necessary to promote the quality and | 0015| cost-effectiveness of health care services provided through the | 0016| health plan. | 0017| Section 21. HEALTH PLAN BUDGET.-- | 0018| A. Each year, the commission shall develop a health | 0019| plan budget. The budget shall establish the total amount to be | 0020| spent by the plan for covered health care services in the next | 0021| year. The budget shall include provider budgets and global | 0022| budgets. | 0023| B. Unless otherwise provided in the general | 0024| appropriation act or other act of the legislature, the health | 0025| plan budget shall be within projected annual revenues. | 0001| C. In developing the health plan budget, the | 0002| commission shall provide that credit be taken in that budget | 0003| for all revenues produced for health care services and | 0004| facilities in the state pursuant to any law other than the | 0005| Health Care Act. | 0006| Section 22. PROVIDER BUDGET--PAYMENTS TO HEALTH CARE | 0007| PROVIDER--CO-PAYMENTS.-- | 0008| A. Consistent with budget constraints, the health | 0009| plan shall provide payment for all covered health care services | 0010| rendered by health care providers. A variety of payment plans, | 0011| including fee-for-service, compensation caps and capitated | 0012| payments may be adopted by the commission. Payment plans shall | 0013| be negotiated with providers as provided by regulation. | 0014| B. Different or supplemental payment rates may be | 0015| adopted to provide incentives to help ensure the delivery of | 0016| needed health care services in rural and other underserved | 0017| areas throughout the state. | 0018| C. The annual percentage increase in provider | 0019| budgets shall be no greater than the percentage increase in the | 0020| implicit price deflator using one year prior to implementation | 0021| of the health plan as the baseline year. | 0022| D. Payment, or the offer of payment whether or not | 0023| that offer is accepted, to a health care provider for services | 0024| covered by the health plan shall be payment in full for those | 0025| services. A health care provider shall not charge a patient | 0001| covered under the health plan any additional amounts for | 0002| services covered by the plan. | 0003| E. The commission may set co-payments if co-payment | 0004| is determined to be an effective cost-control measure. No co- | 0005| payment shall be required for preventive care or if it creates | 0006| a barrier to medically necessary care. When a co-payment is | 0007| required, the health care provider or health care facility | 0008| shall not waive the co-payment. | 0009| Section 23. GLOBAL BUDGET--PAYMENTS TO HEALTH CARE | 0010| FACILITIES.-- | 0011| A. A health care facility shall negotiate an annual | 0012| global budget with the commission. The global budget shall be | 0013| based on a base budget of past performance and projected | 0014| changes upward or downward in costs and services anticipated | 0015| for the next year. If a negotiated agreement is not reached, | 0016| the commission shall set the global budget for the health care | 0017| facility. The initial base budget for a health care facility | 0018| shall be based on a twelve-month period that is no later than | 0019| the year the health plan is implemented, appropriately adjusted | 0020| by the implicit price deflator not to exceed five percent a | 0021| year from 1995 to the first global budget. Thereafter, | 0022| increases in global budgets are limited by the implicit price | 0023| deflator. | 0024| B. Different or supplemental payment rates may be | 0025| adopted to provide incentives to help ensure the delivery of | 0001| needed health care services in rural and other underserved | 0002| areas throughout the state. | 0003| C. Each health care provider employed by a globally | 0004| budgeted health care facility shall be paid from the budget | 0005| allocation in a manner determined by the health care facility. | 0006| Section 24. CAPITAL BUDGETS--COMMISSION APPROVAL REQUIRED | 0007| FOR MAJOR CAPITAL EXPENDITURE.-- | 0008| A. The commission shall adopt an annual capital | 0009| budget. | 0010| B. Allocations to geographic areas and to | 0011| individual health care facilities and health care providers | 0012| shall be based on need and shall be calculated so that the | 0013| minimum access standards adopted by the commission are | 0014| considered for all areas of the state, and shall ensure the | 0015| efficient development and operation of necessary facilities. | 0016| C. No major capital expenditure shall be made by a | 0017| health care provider or health care facility without prior | 0018| approval. The director of the commission has approval | 0019| authority for major capital expenditures between fifty thousand | 0020| dollars ($50,000) and five hundred thousand dollars ($500,000), | 0021| based on regulations adopted by the commission. The commission | 0022| has approval authority for major capital expenditures over five | 0023| hundred thousand dollars ($500,000). | 0024| D. The approval of any proposed major capital | 0025| expenditure shall be based on efforts to do all of the | 0001| following: | 0002| (1) fulfill unmet needs; | 0003| (2) preclude unnecessary expansion of | 0004| facilities and services; | 0005| (3) ensure the efficient development of health | 0006| care facilities that are appropriate to the services provided; | 0007| (4) ensure sufficient access to health care | 0008| facilities; and | 0009| (5) ensure access to efficacious new | 0010| technologies. | 0011| E. No health care facility or health care provider | 0012| shall engage in component purchasing to avoid restrictions on | 0013| major capital expenditures. The commission may deduct the | 0014| total cost of component purchases in the next year's capital | 0015| budget or the appropriate operating budget. As used in this | 0016| subsection, "component purchasing" means the purchase of | 0017| component parts or other purchasing practice with the effect of | 0018| circumventing major capital expenditure restrictions. | 0019| F. There is a two-year moratorium on major capital | 0020| expenditures beginning July 1, 1997. The commission may grant | 0021| waivers to the moratorium in emergencies. | 0022| G. No later than January 1, 1998, the commission | 0023| shall report to the appropriate committees of the legislature | 0024| on the capital needs of health care facilities, including | 0025| facilities of state and local governments, with a focus on | 0001| underserved geographic areas with substantially below-average | 0002| health care facilities and investment per capita as compared to | 0003| the state average. The report shall also describe geographic | 0004| areas where the distance to health care facilities imposes a | 0005| barrier to care. The report shall include a section on health | 0006| care transportation needs, including capital, personnel and | 0007| training needs. | 0008| Section 25. ACTUARIAL REVIEW--AUDITS.-- | 0009| A. The commission shall provide for an annual | 0010| independent actuarial review of the health plan and any funds | 0011| of the commission or the plan. | 0012| B. The commission shall provide by regulation for | 0013| independent financial audits of health care providers and | 0014| health care facilities. | 0015| C. The commission, through its staff or by | 0016| contract, shall perform announced and unannounced audits, | 0017| including financial, operational, management and electronic | 0018| data processing audits of health care providers and health care | 0019| facilities. The auditor shall report directly to the | 0020| commission. A copy of the audit report shall be given to the | 0021| state auditor. | 0022| D. Actuarial reviews, financial audits and internal | 0023| audits are public documents after they have been released by | 0024| the commission. | 0025| Section 26. STANDARD CLAIM FORMS FOR INSURANCE PAYMENT.-- | 0001| The commission shall adopt standard claim forms that shall be | 0002| used by all health care providers and health care facilities | 0003| that seek payment through the health plan or from private | 0004| persons, including private insurance companies, for health care | 0005| services rendered in the state. Each claim form may indicate | 0006| whether a person is eligible for federal or other insurance | 0007| programs for payment. Each claim form shall include data | 0008| elements required by the commission. | 0009| Section 27. COMPUTERIZED SYSTEM.--The commission shall | 0010| require that all health care providers and health care | 0011| facilities participate in the health plan's computer network | 0012| that provides for electronic transfer of payments to health | 0013| care providers and health care facilities; transmittal of | 0014| reports, including patient data and other statistical reports; | 0015| billing data, with specificity as to procedures or services | 0016| provided to individual patients; and any other information | 0017| required or requested by the commission. | 0018| Section 28. REPORTS REQUIRED--CONFIDENTIAL INFORMATION.-- | 0019| A. The commission, through the state health | 0020| information system, shall require reports by all health care | 0021| providers and health care facilities of information needed to | 0022| allow the commission to evaluate the health plan, cost- | 0023| containment measures, utilization review, health care facility | 0024| global budgets, health care provider fees and any other | 0025| information the commission deems necessary to carry out its | 0001| duties under the Health Care Act. | 0002| B. The commission shall establish uniform reporting | 0003| requirements for health care providers and health care | 0004| facilities. | 0005| C. Information confidential pursuant to other | 0006| provisions of law shall be confidential under the Health Care | 0007| Act. Within the constraints of confidentiality, reports of the | 0008| commission are public documents. | 0009| Section 29. OMBUDSMAN PROGRAM.-- | 0010| A. The commission shall establish an ombudsman | 0011| program to take complaints and to provide timely and | 0012| knowledgeable assistance to: | 0013| (1) eligible persons and applicants about | 0014| their rights and responsibilities and the coverages provided in | 0015| accordance with the Health Care Act; and | 0016| (2) health care providers and health care | 0017| facilities about status of claims, payments and other pertinent | 0018| information relevant to the claims payment process. | 0019| B. The commission shall establish a toll-free | 0020| telephone line for the ombudsman programs and shall have | 0021| ombudsmen available throughout the state to assist eligible | 0022| persons, applicants, health care providers and health care | 0023| facilities in person. | 0024| Section 30. APPEALS--MEDIATION--FAIR HEARING.-- | 0025| A. An applicant for or recipient of a health care | 0001| service may appeal a decision related to eligibility, covered | 0002| services or a primary care provider's referral decision. | 0003| B. A health care provider or health care facility | 0004| may appeal a decision related to claims, budgets or right to | 0005| practice. | 0006| C. An appeal of a decision may be summarily settled | 0007| by the director if the person filing for an appeal presents | 0008| evidence satisfactory to the director that an erroneous | 0009| decision had been made. If the summary appeal is unsuccessful, | 0010| the person may request mediation or a hearing. | 0011| D. The commission shall by regulation establish | 0012| procedures for a mediation process. The regulations shall | 0013| provide for the selection of a mediator that is acceptable to | 0014| all parties. | 0015| E. The commission shall by regulation establish | 0016| procedures for the filing of a request for hearing and the time | 0017| limits within which a request may be filed. The commission may | 0018| grant reasonable extensions of the time limits. If the request | 0019| for hearing is not filed within the specified time or within | 0020| whatever extension the commission may grant, the initial | 0021| decision shall be final. Upon receipt of a timely request, the | 0022| commission shall give the appellant reasonable notice of an | 0023| opportunity for a fair hearing in accordance with the | 0024| regulations of the commission. | 0025| F. The hearing shall be conducted by a hearing | 0001| officer designated by the director. The hearing officer may be | 0002| an employee of the commission if there is no conflict of | 0003| interest in the appointment of the employee. | 0004| G. The powers of the hearing officer include | 0005| administering oaths or affirmations to witnesses called to | 0006| testify, taking testimony, examining witnesses, admitting or | 0007| excluding evidence and reopening any hearing to receive | 0008| additional evidence. The technical rules of evidence and rules | 0009| of civil procedure shall not apply. The hearing shall be | 0010| conducted so that the contentions or defenses of each party to | 0011| the hearing are amply and fairly presented. Either party may | 0012| be represented by counsel or other representative of his | 0013| designation, and he or his representative may conduct cross- | 0014| examinations. Any oral or documentary evidence may be | 0015| received, but the hearing officer may exclude irrelevant, | 0016| immaterial or unduly repetitious evidence. A verbatim record | 0017| by audio recording or other means shall be made. | 0018| H. The commission shall review the verbatim record | 0019| of the proceedings and shall make a decision based on the | 0020| record. A written notice of decision shall be sent by | 0021| certified mail to the person requesting the hearing. | 0022| Section 31. REVIEW AND APPEAL.-- | 0023| A. Within thirty days after the date written notice | 0024| of the decision of the commission is mailed, an applicant, | 0025| recipient, health care provider or health care facility may | 0001| file a notice of appeal with the court of appeals, together | 0002| with a copy of the notice of the decision. The clerk of the | 0003| court shall transmit a copy of the notice of appeal to the | 0004| director. | 0005| B. The filing of a notice of appeal shall not stay | 0006| the enforcement of the decision of the commission, but the | 0007| commission may grant, or the court upon motion and good cause | 0008| shown may order, a stay. | 0009| C. Appeals shall be taken as provided in the Rules | 0010| of Appellate Procedure. | 0011| D. The review of the court shall be made upon the | 0012| decision and the record of the proceedings. | 0013| E. The court shall set aside a decision and order | 0014| of the commission only if found to be: | 0015| (1) arbitrary, capricious or an abuse of | 0016| discretion; | 0017| (2) not supported by substantial evidence in | 0018| the record as a whole; or | 0019| (3) otherwise not in accordance with law or | 0020| the rules and regulations of the commission. | 0021| Section 32. REIMBURSEMENT FOR OUT-OF-STATE SERVICES-- | 0022| HEALTH PLAN'S RIGHT TO SUBROGATION AND PAYMENT FROM OTHER | 0023| INSURANCE PLANS--CHARGES FOR NON-COVERED PERSONS.-- | 0024| A. If an eligible person needs health care services | 0025| out of state, those services shall be covered at the same rate | 0001| that would apply if the services were received in New Mexico. | 0002| Additional charges for those services shall not be paid by the | 0003| health care plan unless the commission has negotiated a | 0004| reciprocity or other agreement with the other state or foreign | 0005| country or with the out-of-state health care provider or health | 0006| care facility. | 0007| B. If an otherwise eligible person has a separate | 0008| health insurance plan that covers the same services, the health | 0009| plan has the right of subrogation to receive payment from the | 0010| separate health insurance plan for all covered services paid by | 0011| the health plan. In those circumstances, the health plan shall | 0012| be the payer of last resort. Any services provided by a | 0013| separate health insurance plan not covered in the health plan | 0014| shall not be affected. | 0015| C. Nothing in this section affects an ineligible | 0016| person's responsibility for payment of health care services. | 0017| Section 33. PRIVATE HEALTH INSURANCE COVERAGE LIMITED-- | 0018| COMMUNITY RATING REQUIRED.-- | 0019| A. Except as provided in Subsection B of Section 32 | 0020| of the Health Care Act, no person shall provide private health | 0021| insurance to an eligible person for a health care service that | 0022| is covered by the health plan. | 0023| B. Health insurance for a health care service that | 0024| is not covered by the health plan shall be based on a system of | 0025| community rating in which an insurer shall charge the same | 0001| premium for the same coverage to each New Mexico resident, | 0002| regardless of a person's individual circumstances for pre- | 0003| existing condition, medical risk, job risk, age or gender. | 0004| C. Nothing in this section shall be construed to | 0005| affect insurance coverage pursuant to the federal Employee | 0006| Retirement Income Security Act of 1974 unless the state obtains | 0007| a congressional exemption or a waiver from the federal | 0008| government. Businesses that are covered by the provisions of | 0009| that act may elect to participate in the health plan. | 0010| Section 34. FEDERAL HEALTH INSURANCE PROGRAM WAIVERS-- | 0011| REIMBURSEMENT TO PLAN FROM FEDERAL AND OTHER HEALTH INSURANCE | 0012| PROGRAMS.-- | 0013| A. The commission, in conjunction with the human | 0014| services department, shall: | 0015| (1) apply to the United States department of | 0016| health and human services for all waivers of requirements under | 0017| health care programs established pursuant to the federal Social | 0018| Security Act, as amended, that are necessary to enable the | 0019| state to deposit federal payments for services covered by the | 0020| health plan into the plan's fund and to be the supplemental | 0021| payer of benefits for persons receiving medicare benefits; | 0022| (2) identify other federal programs that | 0023| provide federal funds for payment of health care services to | 0024| individuals and apply for any waivers or enter into any | 0025| agreements that are necessary to enable the state to deposit | 0001| federal payments for health care services covered by the health | 0002| plan into the plan's fund; provided, however, agreements | 0003| negotiated with Indian health services shall not impair treaty | 0004| obligations of the United States government and other | 0005| agreements negotiated shall not impair portability or other | 0006| aspects of the health care coverage; and | 0007| (3) seek an amendment to the federal Employee | 0008| Retirement Income Security Act of 1974 to exempt New Mexico | 0009| from the provisions of that act that relate to health care | 0010| services or health insurance, or the commission shall apply to | 0011| the appropriate federal agency for waivers of any requirements | 0012| of that act if congress provides for waivers to enable the | 0013| commission to extend coverage through the Health Care Act to as | 0014| many New Mexicans as possible. | 0015| B. The commission shall seek payment to the health | 0016| plan from medicaid, medicare or any other federal or other | 0017| insurance program for any reimbursable payment provided under | 0018| the plan. | 0019| C. The commission shall seek to maximize federal | 0020| contributions and payments for health care services provided in | 0021| New Mexico and shall ensure that the contributions of the | 0022| federal government for health care services in New Mexico will | 0023| not decrease in relation to other states as a result of any | 0024| waivers, exemptions or agreements. | 0025| Section 35. INSURANCE--COMMISSION APPROVAL.--No person | 0001| shall insure himself or his employees after July 1, 1997 unless | 0002| the coverage terminates on the date that the insureds are | 0003| eligible for coverage under the health plan. Nothing in this | 0004| section prohibits insurance coverage for health care services | 0005| not covered by the health plan or for people not eligible for | 0006| coverage under the health plan. | 0007| Section 36. [NEW MATERIAL] INSURANCE RATES--COMMISSION | 0008| AND SUPERINTENDENT OF INSURANCE DUTIES.-- | 0009| A. The commission shall work closely with the | 0010| superintendent of insurance to identify health care cost | 0011| savings that have been achieved as a result of implementation | 0012| of the health plan. The commission and the superintendent | 0013| shall identify savings by insurance companies on payments made | 0014| for medical services through motor vehicle liability insurance, | 0015| homeowners' insurance, workers' compensation insurance or other | 0016| insurance policies that have a medical payment component. The | 0017| commission and the superintendent shall report their findings | 0018| to the legislature. | 0019| B. The superintendent shall lower insurance | 0020| premiums associated with medical benefits on all types of | 0021| insurance policies written in New Mexico that have a medical | 0022| payment component as soon as data indicate health care savings | 0023| have been achieved as a result of operation of the health plan. | 0024| Section 37. TEMPORARY PROVISION--TRANSITION PERIOD | 0025| ARRANGEMENTS--PUBLICLY FUNDED HEALTH CARE SERVICE PLANS.-- | 0001| A. A person who, on the date benefits are available | 0002| under the Health Care Act health plan, receives health care | 0003| benefits under private contract or collective bargaining | 0004| agreement entered into prior to July 1, 1997 shall continue to | 0005| receive those benefits until the contract or agreement expires | 0006| or unless the contract or agreement is renegotiated to provide | 0007| participation in the health plan. | 0008| B. A person covered by a health care services plan | 0009| that has its premiums paid for in any part by public money, | 0010| including money from the state, a political subdivision, state | 0011| educational institution, public school or other entity that | 0012| receives public money to pay health insurance premiums, shall | 0013| be covered by the Health Care Act health plan on the effective | 0014| date that benefits are available under the plan. | 0015| Section 38. EFFECTIVE DATE.--The effective date of the | 0016| provisions of this act is July 1, 1997. | 0017|  | 0018| | 0019| FORTY-THIRD LEGISLATURE | 0020| FIRST SESSION, 1997 | 0021| | 0022| | 0023| March 10, 1997 | 0024| | 0025| Mr. President: | 0001| | 0002| Your PUBLIC AFFAIRS COMMITTEE, to whom has been | 0003| referred | 0004| | 0005| SENATE BILL 1240 | 0006| | 0007| has had it under consideration and reports same with | 0008| recommendation that it DO NOT PASS, but that | 0009| | 0010| SENATE PUBLIC AFFAIRS COMMITTEE SUBSTITUTE FOR | 0011| SENATE BILL 1240 | 0012| | 0013| is reported WITHOUT RECOMMENDATION, and thence referred to | 0014| the CORPORATIONS & TRANSPORTATION COMMITTEE. | 0015| | 0016| Respectfully submitted, | 0017| | 0018| | 0019| | 0020| __________________________________ | 0021| Shannon Robinson, Chairman | 0022| | 0023| | 0024| Adopted_______________________ Not Adopted_______________________ | 0025| (Chief Clerk) (Chief Clerk) | 0001| | 0002| Date ________________________ | 0003| | 0004| | 0005| The roll call vote was 4 For 3 Against | 0006| Yes: 4 | 0007| No: Adair, Boitano, Ingle | 0008| Excused: Vernon | 0009| Absent: None | 0010| | 0011| S1240PA1 SENATE PUBLIC AFFAIRS COMMITTEE SUBSTITUTE FOR | 0012| SENATE BILL 1240 | 0013| 43rd legislature - STATE OF NEW MEXICO - first session, 1997 | 0014| | 0015| | 0016| | 0017| | 0018| | 0019| | 0020| | 0021| AN ACT | 0022| RELATING TO HEALTH CARE; ENACTING THE HEALTH CARE ACT TO | 0023| PROVIDE FOR COMPREHENSIVE STATEWIDE HEALTH CARE; PROVIDING FOR | 0024| HEALTH CARE PLANNING; ESTABLISHING PROCEDURES TO CONTAIN HEALTH | 0025| CARE COSTS; CREATING A COMMISSION; PROVIDING ITS POWERS AND | 0001| DUTIES; PROVIDING FOR HEALTH CARE DELIVERY REGIONS AND REGIONAL | 0002| COUNCILS. | 0003| | 0004| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO: | 0005| Section 1. SHORT TITLE.--This act may be cited as the | 0006| "Health Care Act" | 0007| Section 2. PURPOSE OF ACT.--The purposes of the Health | 0008| Care Act are to create a publicly financed statewide health | 0009| program to provide coverage for health care services for all | 0010| state residents and to control escalating health care costs. | 0011| Section 3. DEFINITIONS.--As used in the Health Care Act: | 0012| A. "beneficiary" means a person eligible for coverage | 0013| and benefits pursuant to the health plan; | 0014| B. "capital budget" means that portion of a budget | 0015| that establishes dollar amounts for expenditures for: | 0016| (1) acquisition or addition of substantial | 0017| improvements to real property; and | 0018| (2) acquisition of tangible personal property; | 0019| C. "capitation" means allocation of health plan funds | 0020| to a health care provider based on the number of individuals | 0021| whose health care must be covered by the provider, with respect | 0022| to all benefits available under the health plan, for a calendar | 0023| year or part of a calendar year; | 0024| D. "commission" means the health care commission | 0025| created pursuant to the Health Care Act; | 0001| E. "director" means the director of the commission; | 0002| F. "global budget" means the prospective operating | 0003| budget of a health facility, excluding the capital budget; | 0004| G. "group practice" means a health maintenance | 0005| organization, an association of health care providers that | 0006| provides one or more specialized health care services, such as | 0007| laboratory services, x-ray services, emergency care and | 0008| inpatient or outpatient hospital services, a tribally operated | 0009| health care center or tribal coalitions in partnership or under | 0010| contract with the Indian health service that is authorized | 0011| under federal law to provide health care to Native American | 0012| populations in the state; | 0013| H. "health care provider" means: | 0014| (1) a person licensed or certified in New Mexico | 0015| as a: | 0016| (a) physician; | 0017| (b) osteopathic physician; | 0018| (c) physician assistant or osteopathic | 0019| physician's assistant; | 0020| (d) chiropractic physician; | 0021| (e) dentist; | 0022| (f) psychologist, social worker; professional | 0023| clinical mental health counselor, professional mental health | 0024| counselor, marriage and family therapist or registered mental | 0025| health counselor; | 0001| (g) optometrist; | 0002| (h) podiatrist; | 0003| (i) pharmacist; | 0004| (j) pharmacist clinician; | 0005| (k) registered nurse or certified nurse | 0006| practitioner; | 0007| (l) visiting nurse service, private duty | 0008| registry or other certified home health agency; | 0009| (m) doctor of oriental medicine; | 0010| (n) physical therapist; | 0011| (o) massage therapist; | 0012| (p) occupational therapist; | 0013| (q) speech-language pathologist; | 0014| (r) audiologist; | 0015| (s) respiratory care practitioner; | 0016| (t) midwife; | 0017| (u) dietician or nutritionist; | 0018| (v) transportation service; or | 0019| (w) other practitioner of the healing arts | 0020| designated as a health care provider by the commission; | 0021| (2) a person licensed or certified by a nationally | 0022| recognized professional organization and designated as a health | 0023| care provider by the commission as a: | 0024| (a) prosthetist; | 0025| (b) orthotist; or | 0001| (c) oculist; or | 0002| (3) a group practice or transportation service for | 0003| that portion of the group practice or transportation service that | 0004| is paid pursuant to a fee schedule established by the commission; | 0005| I. "health facility" means a clinic, general or special | 0006| hospital, outpatient facility, psychiatric hospital, laboratory, | 0007| skilled nursing facility or nursing facility. For the purpose of | 0008| determining global budgets, "health facility" includes a group | 0009| practice or transportation service; | 0010| J. "health plan" means the mechanism developed by the | 0011| commission for provision of health care services pursuant to the | 0012| Health Care Act; | 0013| K. "health plan budget" means all expenditures for the | 0014| health plan, including the costs of services and benefits | 0015| provided, administration, data gathering and other activities; | 0016| L. "implicit price deflator" means a measure of | 0017| inflation that is published in the United States department of | 0018| commerce survey of current business; | 0019| M. "major capital expenditure" means construction or | 0020| renovation of facilities or the purchase of diagnostic, treatment | 0021| or transportation equipment costing more than an amount | 0022| established by the legislature after the commission completes a | 0023| study and makes recommendations on this matter; | 0024| N. "person" means a legal entity; | 0025| O. "primary care provider" means a licensed physician, | 0001| osteopathic physician, nurse practitioner, physician assistant, | 0002| osteopathic physician's assistant, pharmacist clinician or other | 0003| provider certified by the commission as a primary care provider | 0004| after the commission's determination that the provider provides | 0005| the first level of health care for a beneficiary's health needs; | 0006| P. "provider budget" means the fee schedule established | 0007| by the commission each year to pay for health care services | 0008| provided by health care providers participating in the health | 0009| plan; and | 0010| Q. "transportation service" means the services of an | 0011| ambulance, helicopter or other conveyance that is equipped with | 0012| emergency supplies and equipment and is used to transport patients | 0013| to health care providers or health facilities. | 0014| Section 4. HEALTH CARE COMMISSION CREATED--VOTING AND | 0015| NONVOTING MEMBERS.-- | 0016| A. The "health care commission" is created as an adjunct | 0017| agency pursuant to the Executive Reorganization Act. The general | 0018| services department, the department of health and the human | 0019| services department shall cooperate with the commission and assist | 0020| it as needed. The commission consists of fifteen voting members | 0021| and nine nonvoting members. The voting members, all of whom shall | 0022| be appointed by the governor with the advice and consent of the | 0023| senate, are: | 0024| (1) four persons who represent consumer interests, | 0025| at least one of whom represents elderly consumer interests; | 0001| (2) two persons who represent persons with physical | 0002| or mental impairments that limit one or more of their major life | 0003| activities; | 0004| (3) five persons who represent either health care | 0005| providers or health facilities; | 0006| (4) two persons who represent business ownership | 0007| interests, with one person representing employers of more than | 0008| fifteen persons and one person representing employers of fifteen | 0009| persons or fewer; and | 0010| (5) two persons who represent organized labor. | 0011| B. The voting members appointed shall reflect the | 0012| ethnic, gender, economic and geographic diversity of the state. | 0013| To ensure fair geographic representation of all areas of the | 0014| state, members shall be appointed from each of the state board of | 0015| education districts established by the 1991 Educational | 0016| Redistricting Act as follows: | 0017| (1) two from state board of education district 1; | 0018| (2) one from state board of education district 2; | 0019| (3) one from state board of education district 3; | 0020| (4) two from state board of education district 4; | 0021| (5) two from state board of education district 5; | 0022| (6) one from state board of education district 6; | 0023| (7) two from state board of education district 7; | 0024| (8) two from state board of education district 8; | 0025| (9) one from state board of education district 9; | 0001| and | 0002| (10) one from state board of education district 10. | 0003| C. The initial voting members of the commission shall be | 0004| appointed by the governor by July 1, 1998. The terms of the | 0005| initial voting members appointed shall be staggered as follows: | 0006| five members shall be appointed for a term of four years; five | 0007| members shall be appointed for a term of three years; and five | 0008| members shall be appointed for a term of two years. Thereafter, | 0009| all members shall be appointed for terms of four years. After | 0010| initial terms are served, no member shall serve more than three | 0011| consecutive four-year terms. | 0012| D. A voting member may be removed from the commission | 0013| only for incompetence, neglect of duty or malfeasance in office. | 0014| No voting member shall be removed without having first been given | 0015| notice of hearing and an opportunity to be heard. The supreme | 0016| court has exclusive original jurisdiction over proceedings to | 0017| remove a voting member. The supreme court's decision on removal | 0018| shall be final. | 0019| E. A majority of the commission's voting members | 0020| constitutes a quorum for the transaction of business. Annually | 0021| the commission shall elect its chairman and any other officers it | 0022| deems necessary. | 0023| F. Voting members shall receive per diem and mileage in | 0024| accordance with the provisions of the Per Diem and Mileage Act. | 0025| G. The commission is composed of the following nine | 0001| nonvoting members: | 0002| (1) the secretary of health; | 0003| (2) the secretary of human services; | 0004| (3) the secretary of children, youth and families; | 0005| (4) the secretary of taxation and revenue; | 0006| (5) a person designated by the New Mexico office of | 0007| Indian affairs, after consultation with the federal Indian health | 0008| service; | 0009| (6) two members of the house of representatives, | 0010| including one member of the majority party and one member of the | 0011| minority party, appointed by the speaker of the house; and | 0012| (7) two members of the senate, including one member | 0013| of the majority party and one member of the minority party, | 0014| appointed by the committees' committee of the senate, or, if the | 0015| senate appointments are made in the interim, by the president pro | 0016| tempore of the senate after consultation with and agreement of a | 0017| majority of the members of the committees' committee. | 0018| H. The governor shall recommend to the legislature by | 0019| January 1, 1998 whether or not the members of the commission | 0020| should be compensated. | 0021| Section 5. CONFLICT OF INTEREST.-- | 0022| A. Except for nonvoting members and members appointed to | 0023| represent health facilities or health care providers, no | 0024| commission member or a member of his immediate family shall have | 0025| any financial interest, direct or indirect, in a person providing | 0001| health care services or health insurance. | 0002| B. The commission shall adopt a conflict of interest | 0003| disclosure statement for use by all members that requires | 0004| disclosure of financial interests of the member or a member of his | 0005| immediate family in a person providing the health care services or | 0006| health insurance. | 0007| C. No member of the commission shall vote on any matter | 0008| in which he or a member of his immediate family has a financial | 0009| interest, except that members representing health facilities or | 0010| health care providers may vote on matters that pertain generally | 0011| to health facilities or health care providers. | 0012| D. If there is a question about a conflict of interest | 0013| of a member, the commission shall vote on whether to allow the | 0014| member to vote. | 0015| Section 6. DIRECTOR--STAFF--CONTRACTS--BUDGETS.-- | 0016| A. To assist in carrying out its duties, the commission | 0017| shall appoint and set the salary of a "director", subject to the | 0018| provisions of Section 10-9-5 NMSA 1978. The director shall serve | 0019| at the pleasure of the commission. | 0020| B. The director may employ those persons necessary to | 0021| administer and implement the provisions of the Health Care Act. | 0022| Employees are subject to the provisions of the Personnel Act. | 0023| C. The director and his staff shall implement the Health | 0024| Care Act in accordance with that act and the policies and | 0025| regulations adopted by the commission. The director may delegate | 0001| authority to employees and may organize the staff into units to | 0002| facilitate its work. | 0003| D. If the director determines that commission staff or | 0004| another state agency does not have the resources or expertise to | 0005| perform a necessary task, the commission may contract with a | 0006| person that has a demonstrated capability to perform the task. If | 0007| claims processing is provided by contract, that contract shall | 0008| require that all work shall be performed entirely in New Mexico. | 0009| All contracts shall be reviewed at least every two years to ensure | 0010| that they continue to meet the criteria and performance standards | 0011| of the contract and the needs of the commission. | 0012| E. The director may contract with consultants that the | 0013| director deems necessary to advise him or the commission in | 0014| carrying out the provisions of the Health Care Act. | 0015| F. The director shall prepare an annual budget and plan | 0016| of operation for the commission. He shall submit both to the | 0017| commission for its approval before implementation. | 0018| Section 7. COMMISSION--GENERAL POWERS AND DUTIES.--The | 0019| commission shall: | 0020| A. adopt a five-year program of operation to implement | 0021| the provisions of the Health Care Act; | 0022| B. provide a program to educate the public, health care | 0023| providers and health facilities about the health plan and the | 0024| persons eligible to receive its benefits; | 0025| C. study and adopt the most cost-effective methods of | 0001| providing health care services to all beneficiaries, according | 0002| high priority to increased reliance on: | 0003| (1) preventive and primary care that shall include | 0004| immunization and screening examinations; | 0005| (2) providing health care services in rural or | 0006| undeserved areas of the state; | 0007| (3) in-home and community-based alternatives to | 0008| institutional care; and | 0009| (4) case management services when appropriate; | 0010| D. establish compensation mechanisms for health care | 0011| providers and adopt standards and procedures for negotiating and | 0012| entering into contracts with participating health care providers; | 0013| E. establish a health plan budget; | 0014| F. establish global budgets for health facilities and | 0015| adopt: | 0016| (1) standards and procedures for determining base | 0017| budgets and annual global budgets for health facilities; and | 0018| (2) a capital expenditure program that requires | 0019| prior approval for major capital expenditures by health | 0020| facilities; | 0021| G. negotiate and enter into health care reciprocity | 0022| agreements with other states and foreign countries and negotiate | 0023| and enter into health care agreements with out-of-state health | 0024| care providers and health facilities; | 0025| H. develop a payment system for health care providers | 0001| and health facilities that ensures continuity of payments to | 0002| enable the providers and facilities to meet their financial | 0003| obligations as they become due; | 0004| I. establish a system to collect and analyze health care | 0005| data and other data necessary to improve the quality, efficiency | 0006| and effectiveness of health care services and to control costs of | 0007| health care services in New Mexico, and at a minimum the system | 0008| shall include data on: | 0009| (1) mortality, including accidental causes of | 0010| death, and natality; | 0011| (2) morbidity; | 0012| (3) health behavior; | 0013| (4) physical and psychological impairment and | 0014| disability; | 0015| (5) health care services system costs and health | 0016| care services availability, utilization and revenues; | 0017| (6) environmental factors; | 0018| (7) availability, adequacy and training of health | 0019| care services personnel; | 0020| (8) demographic factors; | 0021| (9) social and economic conditions affecting | 0022| health; and | 0023| (10) other factors determined by the commission; | 0024| J. standardize data collection and specific methods of | 0025| measurement across databases and use scientific sampling or | 0001| complete enumeration for reporting health information; | 0002| K. establish a health care services delivery system that | 0003| is efficient to administer and that eliminates unnecessary | 0004| administrative costs; | 0005| L. adopt rules and regulations necessary to implement | 0006| and monitor a state formulary to provide prescription drugs, | 0007| medicine, durable medical equipment and supplies, eyeglasses, | 0008| hearing aids, oxygen and related services; | 0009| M. study and evaluate the adequacy and quality of health | 0010| care services furnished pursuant to the Health Care Act, the cost | 0011| of each type of service and the effectiveness of cost-containment | 0012| measures in the health plan; | 0013| N. study and monitor the migration of persons to New | 0014| Mexico to determine if persons with costly health care needs are | 0015| moving to New Mexico to receive health care services, and if | 0016| migration appears to threaten the financial stability of the | 0017| health plan, recommend to the legislature changes in eligibility | 0018| requirements, premiums or other statutory changes that may be | 0019| necessary to maintain the financial integrity of the health plan; | 0020| O. study and evaluate the cost of health care provider | 0021| professional liability and health care provider professional | 0022| liability insurance and recommend statutory changes to the | 0023| legislature as necessary; | 0024| P. establish and approve changes in coverage benefits | 0025| and benefit standards in the health plan; | 0001| Q. conduct necessary investigations and inquiries and | 0002| compel by subpoena the submission of testimony, information and | 0003| documents that the commission considers necessary to carry out its | 0004| duties; | 0005| R. adopt rules and regulations necessary to implement, | 0006| administer and monitor the operation of the health plan; | 0007| S. meet as needed, but no less than once every three | 0008| months; and | 0009| T. report annually to the legislature and the governor | 0010| on the commission's activities and the operation of the health | 0011| plan and include in the annual report: | 0012| (1) a summary of information about health care | 0013| needs, health care services, health care expenditures, revenues | 0014| received and projected revenues and other relevant issues relating | 0015| to the health plan and the five-year program; and | 0016| (2) recommendations on methods to control health | 0017| care costs and improve access to and the quality of health care | 0018| for state residents, as well as recommendations for legislative | 0019| action if any are found to be necessary. | 0020| Section 8. COMMISSION--AUTHORITY.--The commission has the | 0021| authority necessary to carry out all duties and responsibilities | 0022| required of it pursuant to the Health Care Act, whether that | 0023| authority is expressly provided in that act or is necessarily | 0024| implied. The commission may delegate its general authority to the | 0025| director except for specific authority or direction that is | 0001| granted to the commission by a provision of the Health Care Act | 0002| and authority, which is expressly reserved in the commission, to | 0003| take the following actions: | 0004| A. sue and defend suits brought against it, subject to | 0005| the provisions of the Tort Claims Act; | 0006| B. enter into contracts; | 0007| C. approve its budget and plan of operation; | 0008| D. approve the health plan and make changes in the | 0009| health plan; | 0010| E. adopt regulations, written policies and procedures to | 0011| implement the health plan and the provisions of the Health Care | 0012| Act; | 0013| F. issue subpoenas to persons to appear and testify | 0014| before the commission and to produce documents and other | 0015| information, and enforce this subpoena power through an action in | 0016| the district court of Santa Fe county; | 0017| G. make reports and recommendations to the legislature; | 0018| H. apply for program waivers from any governmental | 0019| entity; and | 0020| I. accept grants, apply for and receive loans and accept | 0021| donations. | 0022| Section 9. ADVISORY BOARDS.-- | 0023| A. The commission may establish advisory boards to | 0024| assist it in performing its duties. | 0025| B. The commission shall establish a "health care | 0001| provider advisory board" to advise and assist the commission in | 0002| all decisions requiring the expertise of health care providers. | 0003| Each noncommission member shall represent a different licensed | 0004| health profession. | 0005| C. No more than two advisory board members shall have | 0006| any financial interest, direct or indirect, in a person providing | 0007| health care services or a person providing health insurance. | 0008| D. The commission may appoint commission members and up | 0009| to five additional persons to serve on an advisory board it | 0010| creates. Advisory board members who are not commission members | 0011| may be paid per diem and mileage in accordance with the provisions | 0012| of the Per Diem and Mileage Act. | 0013| E. Staff and technical assistance for an advisory board | 0014| shall be provided by the commission as necessary. | 0015| Section 10. HEALTH CARE DELIVERY REGIONS.--The commission | 0016| shall establish health care delivery regions in the state, based | 0017| on geography and health care resources. The regions may have | 0018| differential fee schedules, global budgets, capital expenditure | 0019| allocations or other features to encourage the provision of health | 0020| care services in rural and other underserved areas. | 0021| Section 11. REGIONAL COUNCILS.-- | 0022| A. The commission shall create regional councils in the | 0023| health care delivery regions of the state. | 0024| B. The regional councils shall be composed of at least | 0025| one of the commission members who lives in the region and five | 0001| other members appointed by the commission. No more than two | 0002| council members shall have any financial interest, direct or | 0003| indirect, in a person providing health care services or a person | 0004| providing health insurance. | 0005| C. Members of a regional council may be paid per diem | 0006| and mileage in accordance with the provisions of the Per Diem and | 0007| Mileage Act. | 0008| D. The regional councils shall hold public hearings to | 0009| receive comments, suggestions and recommendations from the public | 0010| regarding regional health care needs. The councils shall report | 0011| to the commission at times specified by the commission to ensure | 0012| that regional concerns are considered in the development and | 0013| update of the five-year program, fee schedules, global budgets and | 0014| capital expenditure allocations. | 0015| E. Staff and technical assistance for the regional | 0016| councils shall be provided by the commission. | 0017| Section 12. COMMISSION, COUNCILS AND ADVISORY BOARDS-- | 0018| MEETINGS.--All meetings of the commission, councils and advisory | 0019| boards shall be conducted pursuant to the provisions of the Open | 0020| Meetings Act. | 0021| Section 13. RULES AND REGULATIONS.-- | 0022| A. The commission shall adopt regulations necessary to | 0023| carry out the duties of the commission and the provisions of the | 0024| Health Care Act. | 0025| B. No regulation affecting any person outside the | 0001| commission shall be adopted, amended or repealed without a public | 0002| hearing on the proposed action before the commission or a hearing | 0003| officer designated by the commission. The hearing officer may be | 0004| a member of the commission's staff. The hearing shall be held in | 0005| Santa Fe unless the commission determines that it would be in the | 0006| interest of those affected to hold the hearing elsewhere in the | 0007| state. Notice of the subject matter of the regulation, the action | 0008| proposed to be taken, the time and place of the hearing, the | 0009| manner in which interested persons may present their views and the | 0010| method by which copies of the proposed regulation or an amendment | 0011| or repeal of an existing regulation may be obtained shall be | 0012| published once at least thirty days prior to the hearing date in a | 0013| newspaper of general circulation and mailed at least thirty days | 0014| prior to the hearing date to all persons who have made a written | 0015| request for advance notice of hearing. | 0016| C. All rules and regulations adopted by the commission | 0017| shall be filed in accordance with the State Rules Act. | 0018| Section 14. HEALTH PLAN.-- | 0019| A. After notice and public hearing, including taking | 0020| public comment and the reports of the regional councils, the | 0021| commission shall adopt a health plan. | 0022| B. The health plan shall be designed to provide | 0023| comprehensive, necessary and appropriate health care benefits, | 0024| including preventive health care and primary, secondary and | 0025| tertiary health care for acute and chronic conditions. The health | 0001| plan may provide for certain health care services to be phased in | 0002| as the health plan budget allows. | 0003| C. The commission shall specify the health care services | 0004| to be included as covered by the health plan but shall include: | 0005| (1) preventive health services; | 0006| (2) health care provider services; | 0007| (3) health facility inpatient and outpatient | 0008| services; | 0009| (4) laboratory tests and imaging procedures; | 0010| (5) in-home, community-based and institutional | 0011| long-term care services; | 0012| (6) prescription drugs; | 0013| (7) inpatient and outpatient mental health | 0014| services; | 0015| (8) drug and substance abuse services; | 0016| (9) preventive and prophylactic dental services, | 0017| including an annual dental examination and cleaning; | 0018| (10) vision appliances, including medically | 0019| necessary contact lenses; | 0020| (11) medical supplies, durable medical equipment | 0021| and selected assistive devices, including hearing and speech | 0022| assistance devices; and | 0023| (12) experimental or investigational procedures or | 0024| treatments as specified by the commission. | 0025| D. Covered services shall not include: | 0001| (1) surgery for cosmetic purposes other than for | 0002| reconstructive purposes; | 0003| (2) medical examinations and medical reports | 0004| prepared for purchasing or renewing life insurance or | 0005| participating as a plaintiff or defendant in a civil action for | 0006| the recovery or settlement of damages; and | 0007| (3) orthodontic services and cosmetic dental | 0008| services except those cosmetic dental services necessary for | 0009| reconstructive purposes. | 0010| E. The health plan shall specify the services to be | 0011| covered and the amount, scope and duration of benefits. The plan | 0012| shall include a maximum amount or percentage for administrative | 0013| costs, and this maximum, if a percentage, may change in relation | 0014| to the total costs of services provided under the health plan. | 0015| F. The commission shall specify the terms and conditions | 0016| for participation of health care providers and health facilities | 0017| in the health plan. | 0018| G. The health plan shall contain provisions to control | 0019| health care costs so that beneficiaries receive comprehensive | 0020| health services, consistent with budget constraints, including | 0021| needed health care services in rural and other underserved areas. | 0022| H. The health plan shall phase in beneficiaries as their | 0023| participation becomes possible through contracts, waivers or | 0024| federal legislation. The health plan may provide for certain | 0025| preventive health care services to be offered to all New Mexicans | 0001| regardless of eligibility. | 0002| I. The five-year program shall be reviewed by the | 0003| regional councils and the commission annually and revised as | 0004| necessary. Revisions shall be adopted by the commission in | 0005| accordance with Section 13 of the Health Care Act. In projecting | 0006| services under the health plan, the commission shall take all | 0007| reasonable steps to ensure that long-term care, mental health | 0008| services and dental care are provided at the earliest practical | 0009| times consistent with budget constraints. | 0010| Section 15. LONG-TERM CARE.-- | 0011| A. Long-term care may include: | 0012| (1) home- and community-based services, including | 0013| personal assistance and attendant care; | 0014| (2) hospice care; and | 0015| (3) institutional care. | 0016| B. No later than one year after appointment of the | 0017| director, the commission shall appoint an advisory "long-term care | 0018| committee" made up of representatives of health care consumers, | 0019| providers and administrators to develop a plan for integrating | 0020| long-term care into the health plan. The committee shall report | 0021| its plan to the commission no later than one year from its | 0022| appointment. Committee members may receive per diem and mileage | 0023| as provided in the Per Diem and Mileage Act. | 0024| C. The long-term care component of the health plan | 0025| shall provide for service coordination, case management and | 0001| noninstitutional services where appropriate. | 0002| D. Nothing in this section affects long-term care | 0003| services paid through federal programs or private insurance | 0004| subject to the provisions of Sections 34 and 35 of the Health Care | 0005| Act. | 0006| E. Nothing in this section precludes the commission from | 0007| including long-term care services from the inception of the health | 0008| plan. | 0009| Section 16. MENTAL HEALTH SERVICES.-- | 0010| A. Mental health services may include: | 0011| (1) services for acute and chronic conditions; | 0012| (2) home- and community-based services; and | 0013| (3) institutional care. | 0014| B. No later than one year after appointment of the | 0015| director, the commission shall appoint an advisory "mental health | 0016| services committee" made up of representatives of mental health | 0017| care consumers, providers and administrators to develop a plan for | 0018| integrating mental health services into the health plan. The | 0019| committee shall report its plan to the commission no later than | 0020| one year from its appointment. Committee members may receive per | 0021| diem and mileage as provided in the Per Diem and Mileage Act. | 0022| C. The mental health services component of the health | 0023| plan shall provide for service coordination, case management and | 0024| noninstitutional services where appropriate. | 0025| D. Nothing in this section affects mental health | 0001| services paid through federal programs or private insurance | 0002| subject to the provisions of Sections 34 and 35 of the Health Care | 0003| Act. | 0004| E. Nothing in this section precludes the commission from | 0005| including mental health services from the inception of the health | 0006| plan. | 0007| Section 17. MEDICAID COVERAGE--JOINT POWERS AGREEMENTS.--The | 0008| commission may enter into joint powers agreements with the human | 0009| services department in accordance with the Joint Powers Agreements | 0010| Act for the purpose of furthering the goals of the Health Care | 0011| Act. These agreements may provide for certain medicaid functions | 0012| to be administered by the commission to allow the commission to | 0013| implement the health plan. | 0014| Section 18. HEALTH PLAN COVERAGE--CONDITIONS OF ELIGIBILITY | 0015| FOR BENEFICIARIES--NONRESIDENT STUDENTS--ELIGIBILITY CARD-- | 0016| PENALTIES.-- | 0017| A. An individual is eligible as a beneficiary of the | 0018| health plan if the individual has been physically present in New | 0019| Mexico for one year prior to the date of application for | 0020| enrollment in the health plan and if the individual has a present | 0021| intention to remain in New Mexico and not to reside elsewhere. A | 0022| dependent of an eligible individual is included as a beneficiary. | 0023| An individual is not eligible for coverage if he is covered for | 0024| the same or similar benefits pursuant to a private or governmental | 0025| health insurance policy or plan, but he becomes eligible when that | 0001| coverage terminates or agreements or waivers are accomplished | 0002| under which coverage under the health plan is available. | 0003| Individuals covered under the following governmental programs | 0004| shall not be brought into coverage through agreements or waivers: | 0005| (1) federal retiree health plan beneficiaries; | 0006| (2) Indian health service beneficiaries, but | 0007| individuals who are covered by tribal providers that are in | 0008| partnership with or have contracts with the Indian health service | 0009| may be brought under coverage through agreement between the tribal | 0010| providers and the commission; | 0011| (3) active duty military personnel; and | 0012| (4) individuals covered by the federal civilian | 0013| health and medical plan for the uniformed services. | 0014| B. An educational institution shall purchase coverage | 0015| under the health plan for its nonresident students through fees | 0016| assessed to these students. The governing body of an educational | 0017| institution shall set the fees at the amount determined by the | 0018| commission. | 0019| C. A nonresident student at an educational institution | 0020| may demonstrate health insurance or plan coverage by proof of | 0021| coverage under a policy or plan in another state that is | 0022| acceptable to the commission. The fee that students shall be | 0023| assessed shall be specified by the commission. | 0024| D. The commission shall adopt regulations to determine | 0025| proof of an individual's eligibility for the health plan or a | 0001| student's proof of nonresident health insurance or plan coverage. | 0002| E. The commission shall adopt regulations to provide a | 0003| method for the purging of eligibility when a beneficiary is no | 0004| longer eligible for coverage. | 0005| F. A beneficiary shall receive a card as proof of | 0006| eligibility. The card shall be electronically readable and shall | 0007| contain a picture or electronic image, information that identifies | 0008| the beneficiary for treatment and electronic billing and payment | 0009| and any other information the commission deems necessary. | 0010| G. The eligibility card is not transferable. A | 0011| beneficiary who lends his card to another and an individual who | 0012| uses another's card shall be jointly and severally be liable to | 0013| the commission for the full cost of the health care services | 0014| provided to the user. The liability shall be paid in full within | 0015| ten days of billing. Liabilities created pursuant to this section | 0016| shall be collected by the taxation and revenue department in the | 0017| same manner as delinquent taxes are collected pursuant to the Tax | 0018| Administration Act. | 0019| H. A beneficiary who lends his card to another or an | 0020| individual who uses another's card a second time is guilty of a | 0021| misdemeanor and shall be sentenced pursuant to the provisions of | 0022| Section 31-19-1 NMSA 1978. A third or subsequent conviction is a | 0023| fourth degree felony and the offender shall be sentenced pursuant | 0024| to the provisions of Section 31-18-15 NMSA 1978. | 0025| Section 19. PRIMARY CARE PROVIDER--RIGHT TO CHOOSE--ACCESS | 0001| TO SERVICES.-- | 0002| A. Except as provided in the Workers' Compensation Act, | 0003| a beneficiary has the right to choose a primary care provider. If | 0004| he does not choose a primary care provider, one shall be assigned | 0005| to him under procedures in regulations adopted by the commission. | 0006| B. The primary care provider shall be responsible for | 0007| providing health care services other than services in medical | 0008| emergencies. If the expertise of another health care provider is | 0009| needed, the primary care provider shall make a referral to the | 0010| appropriate specialty. Except as provided in Subsections C and E | 0011| of this section, health care provider specialists shall be paid | 0012| pursuant to the health plan only if the patient has been referred | 0013| by the patient's primary care provider. Nothing in this | 0014| subsection prevents a beneficiary from obtaining the services of a | 0015| health care provider specialist and paying the specialist for | 0016| services provided. | 0017| C. The commission shall by regulation specify the | 0018| conditions under which a beneficiary may select a specialist as a | 0019| primary care provider. The commission shall set primary care | 0020| provider rates for specialists when serving as primary care | 0021| providers. | 0022| D. The commission shall by regulation specify how often | 0023| and under what conditions a beneficiary may change his primary | 0024| care provider. | 0025| E. The commission shall by regulation specify when and | 0001| under what circumstances a beneficiary may self-refer, including | 0002| self-referral to chiropractors, acupuncturists, mental health | 0003| professionals and other health care providers who are not primary | 0004| care providers. | 0005| Section 20. DISCRIMINATION PROHIBITED.--No health care | 0006| provider or health facility shall discriminate against or refuse | 0007| to furnish health care services to a beneficiary on the basis of | 0008| race, color, income level, national origin, religion, gender, | 0009| sexual orientation, disabling condition or payment status. | 0010| Nothing in this section shall require a health care provider or | 0011| health facility to provide services to a beneficiary if the | 0012| provider or facility is not qualified to provide the needed | 0013| services and does not offer them to the general public. | 0014| Section 21. GRIEVANCE PROCEDURES.--The commission shall | 0015| adopt regulations to cover and shall implement a prompt and fair | 0016| grievance procedure to respond to complaints of applicants, | 0017| beneficiaries, health care providers and health facilities. | 0018| Section 22. UTILIZATION REVIEW.-- | 0019| A. The commission shall adopt regulations to cover and | 0020| shall implement a comprehensive utilization review program. The | 0021| procedures and standards used in the program shall be disclosed in | 0022| writing to applicants, beneficiaries, health care providers and | 0023| health facilities at the time of application to or participation | 0024| in the health plan. | 0025| B. The decision of the health plan to approve or deny | 0001| health care services for payment shall be made in a timely manner. | 0002| A final decision to deny payment for services shall be made by a | 0003| health care professional having appropriate and adequate | 0004| qualifications to make the decision. The utilization review | 0005| program shall be designed to ensure that beneficiaries have proper | 0006| access to health care services, including referrals to necessary | 0007| specialists. A decision made in the utilization review program | 0008| shall be subject to the grievance procedures under regulations | 0009| adopted pursuant to Section 21 of the Health Care Act. | 0010| Section 23. MONITORING HEALTH CARE PROVIDER PRACTICES.-- | 0011| A. The commission shall adopt regulations to establish | 0012| and implement a continuous quality improvement program that | 0013| monitors the quality and appropriateness of health care services | 0014| provided by the health plan. The commission shall set standards | 0015| and review benefits to ensure that effective, cost-efficient and | 0016| appropriate health care services are rendered. | 0017| B. The commission shall review and adopt professional | 0018| practice guidelines developed by state and national medical and | 0019| specialty organizations, the United States agencies for health | 0020| care policy and research and other organizations as it deems | 0021| necessary to promote the quality and cost-effectiveness of health | 0022| care services provided through the health plan. | 0023| C. The quality improvement program shall include an | 0024| ongoing system for monitoring patterns of practice. The | 0025| commission shall appoint an advisory group consisting of health | 0001| care providers, representatives of health facilities and other | 0002| knowledgeable persons to advise the commission and staff on health | 0003| care practice issues. The advisory group shall provide to the | 0004| commission recommended standards and guidelines to be followed in | 0005| making determinations on practice issues. | 0006| D. The commission shall establish a system of peer | 0007| education for health care providers or health facilities | 0008| determined to be engaging in aberrant patterns of practice. If | 0009| the commission determines that peer education efforts have failed, | 0010| the commission may refer the matter to the appropriate licensing | 0011| or certifying board. | 0012| E. The commission shall provide by regulation the | 0013| procedures for recouping payments or withholding payments for | 0014| health care services determined by the commission to be medically | 0015| unnecessary. In addition, the commission may provide by | 0016| regulation for the assessment of administrative penalties for up | 0017| to three times the amount of excess payments if it finds that | 0018| excessive billings were part of an aberrant pattern of practice. | 0019| Administrative penalties shall be deposited in the current school | 0020| fund. | 0021| F. After consultation with the peer review advisory | 0022| group, the commission may suspend or revoke a health care | 0023| provider's or health facility's privilege to provide health care | 0024| services under the health plan for aberrant patterns of practice, | 0025| including overutilization, unnecessary referrals, attempts to | 0001| unbundle health care services or other practices that the | 0002| commission deems a violation of the Health Care Act or regulations | 0003| adopted pursuant to that act. As used in this section, "unbundle" | 0004| means to divide a service into components in an attempt to | 0005| increase or with the effect of increasing compensation from the | 0006| health plan. | 0007| G. The commission shall report a suspension or | 0008| revocation to practice under the Health Care Act to the | 0009| appropriate licensing or certifying board. | 0010| H. The commission shall report cases of suspected fraud | 0011| by a health care provider or a health facility to the attorney | 0012| general or to the district attorney of the county where the health | 0013| care provider or health facility operates for investigation and | 0014| prosecution. | 0015| Section 24. HEALTH PLAN BUDGET.-- | 0016| A. Each year, the commission shall develop a health plan | 0017| budget. The budget shall establish the total amount to be spent | 0018| by the plan for covered health care services in the next year. | 0019| The budget shall include administrative budgets, provider budgets | 0020| and global budgets. | 0021| B. Unless otherwise provided in the general | 0022| appropriation act or other act of the legislature, the health plan | 0023| budget shall be within projected annual revenues. | 0024| C. In developing the health plan budget, the commission | 0025| shall provide that credit be taken in that budget for all revenues | 0001| produced for health care services and facilities in the state | 0002| pursuant to any law other than the Health Care Act. | 0003| Section 25. PROVIDER BUDGET--PAYMENTS TO HEALTH CARE | 0004| PROVIDER--CO-PAYMENTS.-- | 0005| A. Consistent with budget constraints, the health plan | 0006| shall provide payment for all covered health care services | 0007| rendered by health care providers. A variety of payment plans, | 0008| including fee-for-service, compensation caps and capitated | 0009| payments may be adopted by the commission. Payment plans shall be | 0010| negotiated with providers as provided by regulation. In the event | 0011| that negotiation fails to develop an acceptable payment plan, the | 0012| disputing parties shall submit the payment plan to mediation. The | 0013| commission shall adopt regulations governing the procedures for | 0014| mediation. If the disputed payment plan is not resolved in | 0015| mediation, the disputing parties shall submit the payment plan to | 0016| binding arbitration pursuant to the Uniform Arbitration Act and | 0017| regulations to be adopted by the commission. | 0018| B. Different or supplemental payment rates may be | 0019| adopted to provide incentives to help ensure the delivery of | 0020| needed health care services in rural and other underserved areas | 0021| throughout the state. | 0022| C. The annual percentage increase in provider budgets | 0023| shall be no greater than the percentage increase in the implicit | 0024| price deflator using one year prior to implementation of the | 0025| health plan as the baseline year. | 0001| D. Payment, or the offer of payment whether or not that | 0002| offer is accepted, to a health care provider for services covered | 0003| by the health plan shall be payment in full for those services. A | 0004| health care provider shall not charge a beneficiary any additional | 0005| amounts for services covered by the plan. | 0006| E. The commission may set co-payments if co-payment is | 0007| determined to be an effective cost-control measure. No co-payment | 0008| shall be required for preventive care or if it creates a barrier | 0009| to medically necessary care. When a co-payment is required, the | 0010| health care provider shall not waive the co-payment. | 0011| Section 26. GLOBAL BUDGET--PAYMENTS TO HEALTH FACILITIES-- | 0012| CO-PAYMENTS.-- | 0013| A. A health facility shall negotiate an annual global | 0014| budget with the commission. The global budget shall be based on a | 0015| base budget of past performance and projected changes upward or | 0016| downward in costs and services anticipated for the next year. If | 0017| a negotiated annual global budget is not reached, a health | 0018| facility shall submit the budget to mediation. The commission | 0019| shall adopt regulations governing the procedures for mediation. | 0020| If the disputed budget is not resolved in mediation, the health | 0021| facility shall submit the budget to binding arbitration pursuant | 0022| to the Uniform Arbitration Act and regulations adopted by the | 0023| commission. The initial base budget for a health facility shall | 0024| be based on a twelve-month period that is no later than the year | 0025| the health plan is implemented, appropriately adjusted by the | 0001| implicit price deflator not to exceed five percent a year from | 0002| 1996 to the first global budget. Thereafter, increases in global | 0003| budgets are limited by the implicit price deflator. | 0004| B. Different or supplemental payment rates may be | 0005| adopted to provide incentives to help ensure the delivery of | 0006| needed health care services in rural and other underserved areas | 0007| throughout the state. | 0008| C. Each health care provider employed by a globally | 0009| budgeted health facility shall be paid from the budget allocation | 0010| in a manner determined by the health facility. | 0011| | 0012| D. The commission may set co-payments if co-payment is | 0013| determined to be an effective cost-control measure. No co-payment | 0014| shall be required for preventive care or if it creates a barrier | 0015| to medically necessary care. When a co-payment is required, the | 0016| health facility shall not waive the co-payment. | 0017| Section 27. HEALTH RESOURCE CERTIFICATE--COMMISSION | 0018| REGULATIONS--REQUIREMENT FOR REVIEW.-- | 0019| A. The commission shall adopt regulations pertaining to | 0020| when a health facility or health care provider must apply for a | 0021| health resource certificate, how the application will be reviewed, | 0022| how the certificate will be granted, how an expedited review is | 0023| conducted and other matters relating to health resource projects. | 0024| B. No health facility or health care provider shall | 0025| undertake a capital project or obligate a health facility or | 0001| health care provider to undertake a project without first | 0002| obtaining a health resource certificate, except as provided in | 0003| Subsection F of this section. | 0004| C. No health facility or health care provider shall | 0005| acquire through rental, lease or comparable arrangement or through | 0006| donation all or a part of a capital project that would have | 0007| required review if the acquisition had been by purchase unless the | 0008| project is granted a health resource certificate. | 0009| D. No health facility or health care provider shall | 0010| engage in component purchasing in order to avoid the provisions of | 0011| this section. | 0012| E. The commission shall grant a health resource | 0013| certificate for a capital project only when the project is | 0014| determined to be needed. | 0015| F. This section does not apply to: | 0016| (1) the purchase, construction or renovation of | 0017| office space for health care providers; | 0018| (2) a capital project for which a binding | 0019| contractual obligation was incurred prior to the effective date of | 0020| this section; | 0021| (3) expenditures incurred solely in preparation for | 0022| a capital project, including architectural design, surveys, plans, | 0023| working drawings and specifications and other related activities, | 0024| but those expenditures shall be included in the cost of a project | 0025| for the purpose of determining whether a health resource | 0001| certificate is required; | 0002| (4) acquisition of an existing health facility, | 0003| equipment or practice of a health care provider that does not | 0004| result in a new service being provided or in increased bed | 0005| capacity; | 0006| (5) capital expenditures for nonclinical services | 0007| when the nonclinical services are the primary purpose of the | 0008| expenditure; and | 0009| (6) the replacement of equipment with equipment | 0010| that has the same function and that does not result in the | 0011| offering of new services. | 0012| G. No later than January 1, 1999, the commission shall | 0013| report to the appropriate committees of the legislature on the | 0014| capital needs of health facilities, including facilities of state | 0015| and local governments, with a focus on underserved geographic | 0016| areas with substantially below-average health facilities and | 0017| investment per capita as compared to the state average. The | 0018| report shall also describe geographic areas where the distance to | 0019| health facilities imposes a barrier to care. The report shall | 0020| include a section on health care transportation needs, including | 0021| capital, personnel and training needs. The report shall make | 0022| recommendations for legislation to amend the Health Care Act by | 0023| adding to that act dollar limitations to apply in denying or | 0024| approving capital expenditures. | 0025| Section 28. ACTUARIAL REVIEW--AUDITS.-- | 0001| A. The commission shall provide for an annual | 0002| independent actuarial review of the health plan and any funds of | 0003| the commission or the plan. | 0004| B. The commission shall provide by regulation for | 0005| independent financial audits of health care providers and health | 0006| facilities. | 0007| C. The commission, through its staff or by contract, | 0008| shall perform announced and unannounced audits, including | 0009| financial, operational, management and electronic data processing | 0010| audits of health care providers and health facilities. The | 0011| auditor shall report directly to the commission. A copy of the | 0012| audit report shall be given to the state auditor. | 0013| D. Actuarial reviews, financial audits and internal | 0014| audits are public documents after they have been released by the | 0015| commission. | 0016| Section 29. STANDARD CLAIM FORMS FOR INSURANCE PAYMENT.--The | 0017| commission shall adopt standard claim forms that shall be used by | 0018| all health care providers and health facilities that seek payment | 0019| through the health plan or from private persons, including private | 0020| insurance companies, for health care services rendered in the | 0021| state. Each claim form may indicate whether a person is eligible | 0022| for federal or other insurance programs for payment. Each claim | 0023| form shall include data elements required by the commission. | 0024| Section 30. COMPUTERIZED SYSTEM.--The commission shall | 0025| require that all health care providers and health facilities | 0001| participate in the health plan's computer network that provides | 0002| for electronic transfer of payments to health care providers and | 0003| health facilities; transmittal of reports, including patient data | 0004| and other statistical reports; billing data, with specificity as | 0005| to procedures or services provided to individual patients; and any | 0006| other information required or requested by the commission. | 0007| Section 31. REPORTS REQUIRED--CONFIDENTIAL INFORMATION.-- | 0008| A. The commission, through the state health information | 0009| system, shall require reports by all health care providers and | 0010| health facilities of information needed to allow the commission to | 0011| evaluate the health plan, cost-containment measures, utilization | 0012| review, health facility global budgets, health care provider fees | 0013| and any other information the commission deems necessary to carry | 0014| out its duties under the Health Care Act. | 0015| B. The commission shall establish uniform reporting | 0016| requirements for health care providers and health facilities. | 0017| C. Information confidential pursuant to other provisions | 0018| of law shall be confidential under the Health Care Act. Within | 0019| the constraints of confidentiality, reports of the commission are | 0020| public documents. | 0021| Section 32. OMBUDSMAN PROGRAM.-- | 0022| A. The commission shall establish an ombudsman program | 0023| to take complaints and to provide timely and knowledgeable | 0024| assistance to: | 0025| (1) eligible persons and applicants about their | 0001| rights and responsibilities and the coverages provided in | 0002| accordance with the Health Care Act; and | 0003| (2) health care providers and health facilities | 0004| about status of claims, payments and other pertinent information | 0005| relevant to the claims payment process. | 0006| B. The commission shall establish a toll-free telephone | 0007| line for the ombudsman programs and shall have ombudsmen available | 0008| throughout the state to assist beneficiaries, applicants, health | 0009| care providers and health facilities in person. | 0010| Section 33. REIMBURSEMENT FOR OUT-OF-STATE SERVICES--HEALTH | 0011| PLAN'S RIGHT TO SUBROGATION AND PAYMENT FROM OTHER INSURANCE | 0012| PLANS--CHARGES FOR NON-COVERED PERSONS.-- | 0013| A. If a beneficiary needs health care services out of | 0014| state, those services shall be covered at the same rate that would | 0015| apply if the services were received in New Mexico. Additional | 0016| charges for those services shall not be paid by the health plan | 0017| unless the commission has negotiated a reciprocity or other | 0018| agreement with the other state or foreign country or with the out- | 0019| of-state health care provider or health facility. | 0020| B. The health plan shall make reasonable efforts to | 0021| ascertain any legal liability of third parties who are or may be | 0022| liable to pay all or part of the health care services costs of | 0023| injury, disease or disability of a beneficiary. | 0024| C. When the health plan makes payments on behalf of a | 0025| beneficiary, the health plan is subrogated to any right of the | 0001| beneficiary against a third party for recovery of amounts paid by | 0002| the health plan. | 0003| D. By operation of law, an assignment to the health plan | 0004| of the rights of a beneficiary: | 0005| (1) is conclusively presumed to be made of: | 0006| (a) a payment for health care services from any | 0007| person, firm or corporation, including an insurance carrier; and | 0008| (b) a monetary recovery for damages for bodily | 0009| injury, whether by judgment, contract for compromise or | 0010| settlement; | 0011| (2) shall be effective to the extent of the amount | 0012| of payments by the health plan; and | 0013| (3) shall be effective as to the rights of any | 0014| other beneficiaries whose rights can legally be assigned by the | 0015| beneficiary. | 0016| Section 34. PRIVATE HEALTH INSURANCE COVERAGE LIMITED.-- | 0017| A. After the health plan is effective, no person shall | 0018| provide private health insurance to a beneficiary for a health | 0019| care service that is covered by the health plan except for retiree | 0020| health insurance plans that do not enter into contracts with the | 0021| health plan. | 0022| B. Nothing in this section shall be construed to affect | 0023| insurance coverage pursuant to the federal Employee Retirement | 0024| Income Security Act of 1974 unless the state obtains a | 0025| congressional exemption or a waiver from the federal government. | 0001| Businesses that are covered by the provisions of that act may | 0002| elect to participate in the health plan. | 0003| Section 35. FEDERAL HEALTH INSURANCE PROGRAM WAIVERS-- | 0004| REIMBURSEMENT TO HEALTH PLAN FROM FEDERAL AND OTHER HEALTH | 0005| INSURANCE PROGRAMS.-- | 0006| A. The commission, in conjunction with the human | 0007| services department, shall: | 0008| (1) apply to the United States department of health | 0009| and human services for all waivers of requirements under health | 0010| care programs established pursuant to the federal Social Security | 0011| Act, as amended, that are necessary to enable the state to deposit | 0012| federal payments for services covered by the health plan into the | 0013| plan's fund and to be the supplemental payer of benefits for | 0014| persons receiving medicare benefits; | 0015| (2) identify other federal programs that provide | 0016| federal funds for payment of health care services to individuals | 0017| and apply for any waivers or enter into any agreements that are | 0018| necessary to enable the state to deposit federal payments for | 0019| health care services covered by the health plan into the plan's | 0020| fund; provided, however, agreements negotiated with the Indian | 0021| health service shall not impair treaty obligations of the United | 0022| States government and other agreements negotiated shall not impair | 0023| portability or other aspects of the health care coverage; and | 0024| (3) seek an amendment to the federal Employee | 0025| Retirement Income Security Act of 1974 to exempt New Mexico from | 0001| the provisions of that act that relate to health care services or | 0002| health insurance, or the commission shall apply to the appropriate | 0003| federal agency for waivers of any requirements of that act if | 0004| congress provides for waivers to enable the commission to extend | 0005| coverage through the Health Care Act to as many New Mexicans as | 0006| possible. | 0007| B. The commission shall seek payment to the health plan | 0008| from medicaid, medicare or any other federal or other insurance | 0009| program for any reimbursable payment provided under the plan. | 0010| C. The commission shall seek to maximize federal | 0011| contributions and payments for health care services provided in | 0012| New Mexico and shall ensure that the contributions of the federal | 0013| government for health care services in New Mexico will not | 0014| decrease in relation to other states as a result of any waivers, | 0015| exemptions or agreements. | 0016| Section 36. INSURANCE--COMMISSION APPROVAL.--No person shall | 0017| insure himself or his employees after July 1, 1999 unless the | 0018| coverage terminates on the date that the insureds are eligible for | 0019| coverage under the health plan. Nothing in this section prohibits | 0020| insurance coverage for health care services not covered by the | 0021| health plan or for individuals not eligible for coverage under the | 0022| health plan. | 0023| Section 37. INSURANCE RATES--COMMISSION AND SUPERINTENDENT | 0024| OF INSURANCE DUTIES.-- | 0025| A. The commission shall work closely with the | 0001| superintendent of insurance to identify health care cost savings | 0002| that have been achieved as a result of implementation of the | 0003| health plan. The commission and the superintendent shall identify | 0004| savings by insurance companies on payments made for medical | 0005| services through motor vehicle liability insurance, homeowners' | 0006| insurance, workers' compensation insurance or other insurance | 0007| policies that have a medical payment component. The commission | 0008| and the superintendent shall report their findings to the | 0009| legislature. | 0010| B. The superintendent shall lower insurance premiums | 0011| associated with medical benefits on all types of insurance | 0012| policies written in New Mexico that have a medical payment | 0013| component as soon as data indicate health care savings have been | 0014| achieved as a result of operation of the health plan. | 0015| Section 38. FINANCING THE HEALTH PLAN.-- | 0016| A. The legislative finance committee, in cooperation | 0017| with the New Mexico health policy commission, shall determine | 0018| financing options for the health plan. In making its | 0019| determinations the committee shall be guided by the following | 0020| requirements and assumptions: | 0021| (1) the health plan budget shall be no greater than | 0022| the health care expenditures projected for the 1998 calendar year | 0023| would have been had the health plan been in effect; | 0024| (2) benefits to be costed in determining the | 0025| financing options shall be equivalent to basic health care | 0001| coverage afforded state employees; and | 0002| (3) options shall set minimum and maximum levels of | 0003| premium payments and employer contributions and include a system | 0004| for reasonable co-payments except for preventive care and for | 0005| those beneficiaries at or below one hundred percent of the poverty | 0006| level. | 0007| B. The legislative finance committee shall prepare a | 0008| report of its determinations with the specific options and | 0009| recommendations no later than December 15, 1997. The report shall | 0010| be submitted for consideration for legislative implementation to | 0011| the second session of the forty-third legislature. | 0012| Section 39. TEMPORARY PROVISION--TRANSITION PERIOD | 0013| ARRANGEMENTS--PUBLICLY FUNDED HEALTH CARE SERVICE PLANS.-- | 0014| A. A person who, on the date benefits are available | 0015| under the Health Care Act health plan, receives health care | 0016| benefits under private contract or collective bargaining agreement | 0017| entered into prior to July 1, 1999 shall continue to receive those | 0018| benefits until the contract or agreement expires or unless the | 0019| contract or agreement is renegotiated to provide participation in | 0020| the health plan. | 0021| B. A person covered by a health care services plan that | 0022| has its premiums paid for in any part by public money, including | 0023| money from the state, a political subdivision, state educational | 0024| institution, public school or other entity that receives public | 0025| money to pay health insurance premiums, shall be covered by the | 0001| Health Care Act health plan on the effective date that benefits | 0002| are available under the plan. | 0003| Section 40. EFFECTIVE DATE.--The effective date of the | 0004| provisions of this act is July 1, 1997. | 0005|  |