Healthcare

SB 20 would change how health insurers and pharmacy benefits managers handle prior authorization for prescription drugs in New Mexico. It prohibits requiring prior authorization for medications treating serious mental illnesses (such as schizophrenia, depression, or bipolar disorder), ensuring patients can access these drugs without delays. For drugs managing chronic conditions (like diabetes or high blood pressure), the bill limits prior authorization reviews to once every three years instead of more frequent checks. The law also requires the state insurance office to standardize the process, create a uniform form for requests, and monitor compliance to prevent unnecessary delays in care.

HB 38 requires New Mexico health insurance plans to cover wheelchairs and activity chairs for individuals with permanent mobility-limiting conditions (such as paralysis, limb loss, or neuromuscular disorders) without more restrictive terms than other medical benefits. The bill mandates coverage equivalent to Medicare standards, including all necessary services like fittings, repairs, replacements, and instruction, while prohibiting separate cost-sharing or lifetime limits for these devices. It also ensures insurers must cover out-of-network providers when in-network options are unavailable and reimburse at in-network rates. This applies to all group health plans under the Health Care Purchasing Act.

HB 34 updates New Mexico's school nurse licensure rules to clarify that charter schools must follow the same requirements as public school districts. It establishes three license levels: Level One (a 3-year provisional license requiring mentorship and annual evaluations for new nurses without 3+ years of experience), Level Two (a 9-year license for nurses who complete Level One or have 3+ years of experience), and Level Three (a 9-year license requiring advanced education and leadership skills). The bill sets minimum salaries for each level equal to corresponding teacher salary grades and mandates annual competency reviews by school districts or charter schools. These changes apply to all school nurses employed in New Mexico public and charter schools starting July 1, 2026.

HB 128 presumes that certain cancers and health conditions diagnosed after specific employment periods are caused by firefighting work, directly affecting full-time non-volunteer firefighters in New Mexico. It lists 17 cancer types (like bladder, breast, lung, and leukemia) that are presumed work-related after 5-15 years of service, along with infectious diseases (e.g., hepatitis) and PTSD requiring physical impairment. The bill shifts the burden of proof: employers must rebut these presumptions with evidence showing non-work causes, and medical treatment for covered conditions must be provided as if work-related. This aims to streamline access to workers' compensation for firefighters facing job-linked health issues without requiring them to prove causation in court.

SB 21 requires New Mexico Medicare supplement insurers to offer annual open enrollment periods for seniors. It directly affects residents aged 65+ with Medicare supplement policies (Medigap) in New Mexico. The bill mandates that each eligible policyholder receives a 60-day enrollment window starting the first day of their birthday month, during which they can switch to policies of equal or lesser value without health-based denial, discrimination, or preexisting condition exclusions. Insurers must also notify policyholders 30-60 days before the window opens about their rights and policy changes.

This bill establishes New Mexico's participation in the Interstate Medical Licensure Compact, enabling licensed physicians to more easily practice across participating states. It requires physicians seeking multi-state licensure to maintain a "state of principal license" (their primary practice location) and meet strict eligibility criteria, including no criminal convictions, active licensure, and no pending disciplinary actions. The compact creates a commission to manage applications, verify qualifications, and issue "expedited licenses" without requiring full re-licensure in each state. This primarily affects physicians already licensed in New Mexico who wish to provide care in other participating states, streamlining cross-state medical practice. The bill is pending final approval after passing the House.