New Mexico Statutes

§ 59A-46-65 — Utilization review of mental health or substance use

New Mexico·Ch. 59A Insurance Code·Art. 46 Health Maintenance Organizations

disorder services. A. A carrier shall, at least monthly, review and update the carrier'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, a carrier shall apply criteria in accordance with generally recognized standards of care. C. A carrier shall provide utilization review training to staff and contractors undertaking activities related to utilization review. D. A carrier shall:

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

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Legislative History

Laws 2023, ch. 114, § 29.

Nearby Sections

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