New Mexico § 13-7-34 Utilization review of mental health or substance use

New Mexico Statutes

§ 13-7-34 — Utilization review of mental health or substance use

New Mexico § 13-7-34

Ch. 13Public Purchases and Property

Art. 7Health Care Purchasing

This text of New Mexico § 13-7-34 (Utilization review of mental health or substance use) is published on Counsel Stack Legal Research, covering New Mexico primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

N.M. Stat. Ann. § 13-7-34 (2026).

Text

disorder services. A. An insurer shall, at least monthly, review and update the insurer's utilization review process to reflect the most recent evidence and generally recognized standards of care. B. When performing a utilization review of mental health or substance use disorder services, including level of care placement, continued stay, transfer and discharge, an insurer shall apply criteria in accordance with generally recognized standards of care. C. An insurer shall provide utilization review training to staff and contractors undertaking activities related to utilization review. D. An insurer shall:

(1)develop utilization review policies regarding quantitative and non- quantitative limitations for mental health and substance use disorder services coverage that are no more restrictive

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disorder services. A. An insurer shall, at least monthly, review and update the insurer's utilization review process to reflect the most recent evidence and generally recognized standards of care. B. When performing a utilization review of mental health or substance use disorder services, including level of care placement, continued stay, transfer and discharge, an insurer shall apply criteria in accordance with generally recognized standards of care. C. An insurer shall provide utilization review training to staff and contractors undertaking activities related to utilization review. D. An insurer shall: (1) develop utilization review policies regarding quantitative and non- quantitative limitations for mental health and substance use disorder services coverage that are no more restrictive than the utilization review policies regarding quantitative and non-quantitative limitations for medical and surgical care; and (2) make utilization review policies available to providers or plan members.