TOXICOLOGY REIMBURSEMENT REQUIREMENTS

SB 205 requires New Mexico's Medicaid program to reimburse independent reference laboratories for toxicology testing (like drug screening) at rates matching the average Medicaid fee-for-service rate for drug testing. It mandates reimbursement only when tests are medically necessary (as determined by a provider) and follow evidence-based protocols, including specific frequency guidelines: weekly for new substance use disorder treatment, monthly for stable recovery, and randomized testing when appropriate. The bill defines "independent reference laboratories" as those not affiliated with hospitals, insurers, or physician groups, and appropriates $100,000 for administration in fiscal year 2027. This affects Medicaid patients receiving substance use disorder treatment, the laboratories providing tests, and the state's Medicaid authority.