This bill amends various sections of the Health Care Purchasing Act and the New Mexico Insurance Code to establish an exemption from the prohibition on cost sharing for behavioral health services for certain health plans. Specifically, it mandates that group health coverage, individual or group health insurance policies, and health maintenance organization contracts that provide coverage for behavioral health services cannot impose cost sharing on those services when provided in-network. The bill defines "behavioral health services" to include a range of treatments for mental illnesses, substance abuse disorders, and trauma spectrum disorders, as well as related medications.

Additionally, the bill clarifies the definitions of cost-sharing methods such as coinsurance and copayment, while also specifying that these provisions do not apply to excepted benefit plans, catastrophic plans, or high-deductible health plans until the enrollee's deductible has been met, unless federal law allows otherwise. The effective date for the provisions of this act is set for January 1, 2026.

Statutes affected:
introduced version: 13-7-26, 59A-22-57, 59A-23-16, 59A-46-57, 59A-47-51
PA substitute: 13-7-26, 59A-22-57, 59A-23-16, 59A-46-57, 59A-47-51
Final Version: 13-7-26, 59A-22-57, 59A-23-16, 59A-46-57, 59A-47-51