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SB 317: No Behavioral Health Cost Sharing

Date: 12/23/21

Senate Bill 317, titled “No Behavioral Health Cost Sharing”, which was signed into law by Governor Michelle Lujan Grisham on April 8, 2021, will become effective January 1, 2022 and is scheduled to expire on December 31, 2026. Among other advancements, SB317 prohibits cost sharing, including imposition of a deductible, for behavioral health (“BH”) services covered by any health care plan “delivered, issued for delivery or renewed in New Mexico”. To ensure that all New Mexicans receive equal treatment with respect to health plan coverage for BH services, the application of the prohibition on cost-sharing for BH services must be standardized across all subject health plans on January 1, 2022. To that end, the New Mexico Office of Superintendent of Insurance (“OSI”) directs every subject health plan to use the following criteria to identify BH services that are not subject to cost sharing, listed by service type. This notice applies to Medicaid, Medicare ( Wellcare) and Marketplace (Ambetter)  plans in place on January 1, 2022.

 

Click below to view services that will be reimbursed at the full contracted rate:

SB 317 Information (PDF)