May 19, 2015
On March 25, 2015, Superintendent of Insurance Franchini issued Bulletin No. 2015-013. This bulletin relates to the provision of autism benefits in individual and small group plans. New Mexico’s autism coverage mandate, which predates PPACA, directs carriers to include autism spectrum benefits in their major medical plans. However, the mandate includes limits that, due to PPACA, are no longer allowed, and therefore no longer enforceable, in the individual or small group market. While there is an exception permitting continued limits in large plans, the bulletin reminds insurers that the MHPAEA requires many insurance plans that cover mental health or substance use disorders (including autism spectrum disorders) to offer coverage for those services that is no more restrictive than the coverage for medical/surgical conditions.
Bulletin No. 2015-013 »