The bill amends the Health Care Purchasing Act and the New Mexico Insurance Code to require group health plans to provide coverage for wheelchairs, activity chairs, prosthetic devices, and custom orthotic devices. It mandates that this coverage must be at least equivalent to that offered by the federal Medicare program and is necessary for individuals with documented permanent physical conditions that significantly limit mobility. The bill prohibits health plans from imposing more restrictive financial requirements or spending limits on these items compared to other medical and surgical benefits. Additionally, it establishes that denying coverage for these mobility aids constitutes an unfair and deceptive practice, particularly for individuals with disabilities.

Moreover, the bill introduces specific language that health plans must include in their coverage documents, outlining the rights of insured individuals regarding these benefits. It allows for the replacement of mobility devices without restrictions on continuous use or useful lifetime, as long as a healthcare provider deems it necessary due to changes in the patient's condition or irreparable damage to the item. The bill also defines "activity chair" and ensures that coverage is available from at least two distinct providers within the network. These provisions will apply to policies issued or renewed on or after January 1, 2027, aiming to enhance accessibility and support for individuals with mobility impairments.

Statutes affected:
introduced version: 13-7-46, 59A-16-21.4, 59A-22-62, 59A-23-32, 59A-46-72, 59A-47-66