Section 59A-46-31 - Coordination of benefits.

NM Stat § 59A-46-31 (2019) (N/A)

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A. Health maintenance organizations are permitted, but not required, to adopt coordination of benefits provisions to avoid overinsurance and to provide for the orderly payment of claims when a person is covered by two or more group health insurance or health care plans.

B. If health maintenance organizations adopt coordination of benefits, the provisions shall be consistent with the coordination of benefits provisions that are in general use in the state for coordinating coverage between two or more group health insurance or health care plans.

C. To the extent necessary for health maintenance organizations to meet their obligations as secondary carriers under the regulations established by the superintendent, health maintenance organizations shall make payments for services that are:

(1) received from non-participating providers;

(2) provided outside their service areas; or

(3) not covered under the terms of their group contracts or evidence of coverage.

History: 1978 Comp., § 59A-46-31, enacted by Laws 1993, ch. 266, § 30.

Repeals and reenactments. — Laws 1993, ch. 266, § 43 repealed former 59A-46-31 NMSA 1978, as enacted by Laws 1984, ch. 127, § 877, related to contractual relations, and Laws 1993, ch. 266, § 30 enacted a new section, effective January 1, 1994.

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Section 59A-46-30 - Statutory construction and relationship to other laws.

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Section 59A-46-32 - Continuation of coverage and conversion rights; health care plans.