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This page lists some of the action toward parity compliance undertaken by state regulatory agencies since 2008.

Are we missing any actions taken by state regulatory agencies? Let us know at info@paritytrack.org

Action in the Regulatory Arena

05/2018

Primary Focus Mandated Benefit; Provider; Parity
Title/Description General Program Description for Managed Care Organizations
Agency New Mexico Human Services Department
Citation N.M. Code R. § 8.308.9.11(E)
Summary

Managed Care Organizations shall meet all behavioral health parity requirements as set forth in CFR 42, Chapter IV, subchapter C, 438.905 – Parity requirements.

Effective Date 5/1/2018
Notes 8.308.9.11 NMAC – Rp, 8.308.9.11 NMAC, 5/1/2018
Primary Focus Mandated Benefit; Provider
Title/Description Behavioral Health Services for Managed Care Organizations
Agency New Mexico Human Services Department
Citation N.M. Code R. § 8.308.9.19
Summary MCOs must cover the enumerated behavioral health services. Some services include applied behavior analysis, crises services, and comprehensive community support services.
Effective Date 5/1/2018
Notes 8.308.9.19 NMAC – Rp, 8.308.9.19 NMAC, 5/1/2018

03/2015

New Mexico’s Office of the Superintendent of Insurance (OSI) issued a bulletin (pdf | Get Adobe® Reader®) to insurance plans about autism coverage. The bulletin explained that because of the Affordable Care Act (ACA), individual plans and small employer fully-insured plans are not allowed to impose the annual maximums ($36,000) and lifetime maximums ($200,000) for autism care that are specified in the section about autism coverage in the state insurance law (summarized at the bottom of this page).

The bulletin goes on to explain that although this part of the ACA does not apply to large employer fully-insured plans, the Federal Parity Law does, which means the annual maximums and lifetime maximums in the state law cannot be used for autism services if they are not used for other medical services.

The bulletin also asks the Legislature to change the section about autism coverage in the state insurance law so that it references the DSM V, not the DSM IV.

09/2014

New Mexico’s OSI issued a bulletin, (pdf | Get Adobe® Reader®) but withdrew it three days later. There were two sentences in the bulletin about the Federal Parity Law. It stated that plans have to cover behavioral health services “at parity with other medical conditions” if those services are offered.

National Parity Map

View the state parity reports to learn about legislation, regulation, and litigation related to parity implementation

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Common Violations

In seeking care or services, be aware of the common ways parity rights can be violated.