1 / 10

New Mexico Mandated Benefits presented by Michael Batte

New Mexico Mandated Benefits presented by Michael Batte. Insure NM! Council November 22, 2004. Purposes of Mandates. Public policy Level playing field Response to marketplace. Variations of Mandates. Anti-discrimination of providers Children coverage Women’s coverage issues

rafi
Download Presentation

New Mexico Mandated Benefits presented by Michael Batte

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. New MexicoMandated Benefitspresented byMichael Batte Insure NM! Council November 22, 2004 Department of Insurance

  2. Purposes of Mandates • Public policy • Level playing field • Response to marketplace Department of Insurance

  3. Variations of Mandates • Anti-discrimination of providers • Children coverage • Women’s coverage issues • Special needs • Other Department of Insurance

  4. Anti-discrimination • Indemnity coverage – Freedom of Choice provisions • HMO’s – Provider discrimination prohibited Department of Insurance

  5. Children’s coverage • New born • Adopted • Domestic orders • Immunizations • Circumcision • Maximum age • Handicapped continuation Department of Insurance

  6. Women’s coverage issues • Mammograms • Mastectomy & lymph node dissection • Cytologic screening • Prescription contraceptives • Maternity transport • Alpha-fetoprotein IV screening test Department of Insurance

  7. Special conditions • Diabetes • Inborn errors of metabolism • Cancer clinical trials Department of Insurance

  8. Other • Home health care • Smoking cessation • TMJ • Alcohol dependence Department of Insurance

  9. Federal Mandates(Employer sponsored) • Maternity coverage • Mental health parity • Guaranteed issue – small employer Department of Insurance

  10. Cost of state mandates? • Industry trade associations – 15% to 25% • Our HMO’s – have estimated between 10% and 15% • My guess – closer to 3% than 15% • The answer can be determined Department of Insurance

More Related