New Mexico SB354 Fact Sheet

New Mexico enacted its initial telehealth coverage law in 2013 but restrictive language limited telemedicine adoption.  New Mexico recently passed SB354, “Health Coverage for Telemedicine” amends New Mexico’s current telehealth commercial insurance coverage laws to implement complete parity.

The law, which goes into effect June 14, 2019, states “health plan shall provide coverage for services provided via telemedicine to the same extent the health plan covers the same services when those services are provided via in-person consultation or contact.”

Definition
  • Telemedicine is defined as: “telecommunications and information technology to provide clinical health care at a site distinct from the patient.”
  • Covered telecommunications include live video, store-and-forward technology, remote patient monitoring, and telecommunications
Payment Parity

“A health plan shall reimburse for health care services delivered via telemedicine on the same basis and at least the same rate that the group health plan reimburses for comparable services delivered via in-person consultation.”

Service Parity
  • “A group health plan shall not impose any unique condition for coverage of services provided via telemedicine.”
  • Prevents payers from charging extra for any treatment simply because it is covered by telemedicine.
Originating Site
  • “A group health plan shall not impose an originating-site restriction with respect to telemedicine services or distinguish between telemedicine services provided to patients in rural locations and those provided to patients in urban locations…”
  • Eliminates remaining originating site restrictions
External networks

Prohibits payers from limiting coverage to providers who are part of the health plan’s provider network, if no in-network provider is available or accessible to complete telemedicine services.