This bill establishes new Medicaid reimbursement requirements for toxicology services provided by independent reference laboratories in New Mexico. A new section of the Public Assistance Act is created to outline that the authority will set Medicaid reimbursement codes for these services, which will be aligned with the average Medicaid fee-for-service rates for definitive drug testing. The reimbursement will be contingent upon the services being deemed medically necessary by a healthcare provider and adhering to evidence-based clinical protocols. The authority is also tasked with developing rules for reimbursement protocols, considering nationally accepted clinical guidance, and ensuring that independent reference laboratories meet specific eligibility criteria for Medicaid reimbursement.

Additionally, the bill appropriates $100,000 from the general fund to the health care authority for the fiscal year 2027 to support the administration of these Medicaid reimbursement processes. It clarifies that there will be no mandatory minimum or maximum frequency for the reimbursement of toxicology services, allowing providers to order tests based on documented clinical necessity. The provisions of this act are set to take effect on July 1, 2026.