Parity is about fairness. Americans with behavioral health conditions often have more difficulty getting the treatment and services they need when compared to individuals seeking other medical care. Explore parity-related information regarding legislation, statutes, and regulatory actions since the Federal Parity Law was passed in 2008.
New Mexico Parity Law
There are multiple sections in New Mexico law that are relevant to parity and autism coverage.
Please be aware that it is not possible to provide direct links to any of the following sections of the law. To find these sections, go to this link and click on the plus sign next to the folder in the upper left side of the screen that says “statutes, rules, const.” Then click on the plus sign next to the folder that says NMSA (unannotated). Then, underneath chapter 24, click on the plus sign next to the “more” folder. Then, click on “Chapter 59A Insurance Code.”
To find all of the sections listed below, click on the appropriate article once you are on the “Chapter 59A” page and then the appropriate section on the article pages. For example, to find the mental health parity section, click on article “23E Health Insurance Portability”, and then click on section “59A-23E-18 Requirements for Mental Health Benefits…”
Chapter 59A Article 23E Section 18 (59A-23E-18)
Substance Use Disorder
Chapter 59A Article 23 Section 6 (59A-23-6); Chapter 59A Article 47 Section 35 (59A-47-35)
Chapter 59A Article 22 Section 49 (59A-22-49); Chapter 59A Article 23 Section 7.9 (59A-23-7.9); Chapter 59A Article 46 Section 50 (59A-46-50); Chapter 59A Article 47 Section 45 (59A-47-45)
The section about mental health requires large employer fully-insured plans and small employer fully-insured plans to cover mental health services. Plans cannot use treatment limitations or financial requirements for these services unless “identical” treatment limitations and financial requirements are used for other medical services.
There is also two very detailed subsections about exemptions for plans if premium costs rise by 1.5% for small employer fully-insured plans and 2.5% for large employer fully-insured plans.
Substance Use Disorders
Large employer fully-insured plans , small employer fully-insured plans , individual plans and public employee plans are all required to cover autism services for all individuals through age 19 and any individual who is in high school through age 22.
Autism spectrum disorder is defined as anything in the DSM including autistic disorder, Asperger’s disorder, pervasive developmental disorder not otherwise specified, Rett’s disorder, and childhood disintegrative disorder.
Treatment of autism spectrum disorder is defined as speech therapy, occupational therapy, physical therapy and applied behavioral analysis .
Plans do not have to cover any services in Part B of the Individuals with Disabilities Education Improvement Act (IDEA). Plans are not exempted from Part C, however. Part B is for individuals age 3 through age 21. Part C is for children at birth through age 2.
- New Mexico Insurance Division