This bill amends the Health Care Purchasing Act, the Public Assistance Act, and sections of the New Mexico Insurance Code to enhance coverage for coronary artery calcium screening. It mandates that group health coverage, including self-insurance, must provide coverage for eligible insureds to receive coronary artery calcium screenings without imposing cost sharing for those over the age of forty-nine. The bill specifies that screenings should be available every five years for individuals who have previously received a score of zero, and that further screenings are not required if a score greater than zero is obtained. Additionally, the bill clarifies that the provisions do not apply to certain types of insurance plans, such as short-term travel or high-deductible health plans, until the deductible is met.

The bill introduces new definitions related to coronary artery calcium screening, defining it as a computed tomography scan that measures coronary artery calcium for assessing atherosclerosis and abnormal artery structure and function. It also clarifies that "cost sharing" includes deductibles, copayments, or coinsurance, and reiterates the definition of "health care provider" as a licensed professional authorized to provide health care services. Furthermore, the bill removes specific age and risk criteria previously required for individuals to qualify for certain health benefits related to coronary heart disease. The provisions of this act will apply to group health insurance policies, health care plans, or certificates of health insurance that are 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