The bill amends the Health Care Purchasing Act, the Public Assistance Act, and sections of the New Mexico Insurance Code to require coverage for coronary artery calcium screening without cost sharing for individuals over the age of forty-nine. It mandates that group health coverage must provide this screening every five years for those who have previously received a score of zero, while further screenings are not necessary if a score greater than zero is obtained. The bill also expands the definition of eligible insureds and enrollees, ensuring broader access to this preventive service.

Additionally, the bill introduces new definitions, including "cost sharing," which encompasses deductibles, copayments, or coinsurance, and clarifies that these provisions do not apply to certain health insurance plans, such as short-term or high-deductible plans, unless allowed by federal law. It also removes specific age and risk criteria that were previously required for individuals to qualify for certain health benefits related to coronary heart disease. The provisions will take effect for group health insurance policies and related plans delivered, issued for delivery, or renewed in the state on or after January 1, 2026.

Statutes affected:
introduced version: 13-7-24, 27-2-12.31, 59A-23-7.16, 59A-46-50.5, 59A-47-45.7
CT substitute: 13-7-24, 27-2-12.31, 59A-23-7.16, 59A-46-50.5, 59A-47-45.7