HEALTH CARE AUTHORITY MARKET ASSESSMENTS

SB 297 requires New Mexico's Health Care Authority to conduct regional market assessments by July 2026 (and every two years after) to determine average commercial insurance reimbursement rates for covered health services in Arizona, Colorado, Utah, Oklahoma, and Texas. It sets Medicaid reimbursement rates at the higher of either 200% of Medicare rates or the regional average commercial rate for each service. Health care entities receiving increased Medicaid payments must use at least 75% of the revenue increase to boost compensation or hire more staff directly serving patients. This directly affects hospitals, clinics, pharmacies, and other licensed health care providers participating in New Mexico's Medicaid program. The bill aims to align Medicaid payments with regional market rates while mandating that increased funding benefit frontline workers.