Santa Fe, NM - In response to the Public Health Emergency issued by the New Mexico Department of Health on September 15, 2023, declaring a state of public health emergency due to drug abuse, New Mexico’s Superintendent of Insurance, Alice T. Kane, issued an emergency order requiring commercial health insurers to expand timely access to behavioral health services.
In this order, Superintendent Kane requires major medical health insurers to cover out-of-network behavioral health services at costs applied to comparable in-network services such as primary care physician or specialist visits or inpatient hospital stays. In-network behavioral health services will continue to be provided with no out-of-pocket costs pursuant to Senate Bill 317, Sponsored by Senators Hickey and Steinborn, passed in 2021.
“The effects of untreated substance use disorders and behavioral health conditions have been devastating to the people of New Mexico.” said Superintendent Kane. “My office is committed to reducing barriers to vital care and doing everything we can to improve timely access to critical behavioral health care services.” Health insurance carriers regulated by OSI are required to cover these out-of-network services at in-network levels. “
The Superintendent’s order is effective September 19, 2023 and applies to all fully-insured individual, small and large group health plans, including those sold through the New Mexico health insurance marketplace, beWellnm. . Consumers can consult the back of their health insurance ID card to determine whether the order applies to them. If the card references OSI’s Managed Health Care Bureau (MHCB) for consumer assistance, the order applies to your coverage.
For additional information or questions please contact Viara Ianakieva ([email protected]), Life & Health Division Director.
If you need to file a complaint regarding non-payment of claims or benefit denial, please contact Gurranttanpal “Mickey” Singh ([email protected]), Managed Health Care Bureau Staff Manager.