New Mexico State-Regulated Insurance Coverage

New Mexico requires meaningful coverage for autism under state regulated plans.

New Mexico’s autism insurance bill, SB 39, was enacted in 2009 and became effective on January 1, 2010. Enhancements to its initial coverage have been made since then. In 2013, HB 22 added coverage for state employees and became effective on January 1, 2015. In 2019, HB 322 removed age and dollar caps from the law, expanding coverage to transition-age youth and adults with autism. This expansion went into effect June 15, 2019.

To which plan types does the STATE autism insurance law apply?

  • State Employee Health Plans - YES
  • Individual Plans - YES
  • Fully Insured Large Group Plans - YES
  • Fully Insured Small Group Plans - YES

What services are covered by law?

  • Screening and diagnosis
  • Applied Behavior Analysis
  • Speech, occupational and physical therapy

Does New Mexico have caps on ABA coverage?

No. Legislation passed in 2019 eliminated previous caps in coverage.

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law that generally prevents group health plans and health insurance issuers that provide mental health or substance use disorder (MH/SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits.  This includes quantitative treatment limits like age and dollar caps.  Learn more here.

Where can I find more details about the New Mexico autism insurance law?

A copy of SB 39 (2009) as enrolled can be found here.

A copy of HB 22 (2013) as enrolled can be found here.

A copy of HB 322 (2019) as enrolled can be found here.

If you have any additional questions, please email advocacy@autismspeaks.org.

 

Last Updated: December 2019

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