§ 13-7-25 — Coverage for individuals with diabetes; insulin for

diabetes; cost-sharing cap. A. Group health care coverage, including any form of self-insurance, offered, issued or renewed under the Health Care Purchasing Act shall cap the amount an insured is required to pay for a preferred formulary prescription insulin drug or a medically necessary alternative at an amount not to exceed a total of twenty-five dollars ($25.00) per thirty-day supply and shall provide coverage for individuals with diabetes as required by law for each health care insurer, including: (1) group health insurance policies, health care plans, certificates of health insurance and managed health care plans delivered or issued for delivery in New Mexico; (2) group health plans provided through a cooperative; (3) group health maintenance organization contracts delivered or issued for delivery in New Mexico; and (4) health benefit plans. B. As used in this section, "health care insurer" means a person who provides health insurance in this state, including a licensed insurance company, a licensed fraternal benefit society, a prepaid hospital or medical service plan, a health maintenance organization, a managed care organization, a nonprofit health care organization, a multiple-employer welfare arrangement or any other person providing a plan of health insurance subject to state regulation.

Legislative History

Laws 2020, ch. 36, § 1; 2023, ch. 50, § 1.