N.M. Stat. § 27-2-12.25

This is the official text of N.M. Stat. § 27-2-12.25, part of New Mexico’s Stat — part of the compiled statutory law of New Mexico, published by the state as "Stat." Browse the sections below, each linked to its official government source.

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§ 27-2-12.25. Prior authorization for gynecological or obstetrical ultrasounds prohibited

Official statutory text

A. The department shall prohibit its medicaid managed care and fee-for-service contractors from requiring prior authorization for gynecological or obstetrical ultrasounds.

B. Nothing in this section shall be construed to require payment for a gynecological or obstetrical ultrasound that is not:

(1) medically necessary; or

(2) a covered benefit.

C. As used in this section, “ prior authorization ” means advance approval that is required as a condition precedent to payment for medical care or related benefits rendered to a covered person, including prospective or utilization review conducted prior to the provision of covered medical care or related benefits.

Status: in_force

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