SB 130 — NO COST-SHARING OF CERTAIN DRUGS
Last action — action postponed indefinitely
-
✓Introduced
-
2In Committee
-
3Passed Senate
-
4Passed House
-
5To Executive
-
6Enacted
This bill is in committee in the Senate. Introduced January 23, 2026. It must pass committee before a floor vote.
Next likely step: a committee vote, then a floor vote in the Senate.
Prognosis
Where this bill stands today.
Odds of enactment
LowHow often bills like it became law.
-
In Committee
Current position in the legislative process.
-
1 sponsor
1 primary, 0 co-sponsors signed on.
-
Single-party support
Sponsorship is currently within one party (1 D).
Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.
Bill Text
What changed in the latest version
546 added · 634 removedPlain-language change summary
The latest version of Bill SB 130 introduces changes to how health insurance coverage is defined for coronary artery calcium screenings and cholesterol tests. It specifically removes references to the Health Care Purchasing Act, instead focusing on a broader range of health insurance policies in New Mexico and clarifying eligibility criteria for these screenings. This matters because it could make important health screenings more accessible to a wider group of people, potentially leading to better health outcomes. Additionally, the bill now emphasizes the role of the Board of Pharmacy in overseeing these changes.
SENATE BILLHEALTH 130AND 57THPUBLIC LEGISLATURE-AFFAIRS STATECOMMITTEE OFSUBSTITUTE NEWFOR MEXICOSENATE -BILL SECOND130 SESSION,57TH 2026LEGISLATURE INTRODUCED-STATEOFNEWMEXICO- BYSECOND MartinSESSION Hickey, 2026 4 6 8 10 AN ACT RELATING TO HEALTH CARE;
AMENDING THE HEALTH CARE PURCHASING ACT AND SECTIONS OF THE NEW MEXICO INSURANCE CODE TO PROHIBIT COST SHARING FOR GENERIC MEDICATIONS USED FOR THE TREATMENT OF CHOLESTEROL DISORDER, SECOND-LINE STEP THERAPY MEDICATIONS AND CORONARY ARTERY CALCIUM SCREENING UNDER CERTAIN CIRCUMSTANCES;
BROADENING ELIGIBILITY FOR CORONARY ARTERY CALCIUM SCREENING e t 17 AND CHOLESTEROL LIPID PANELS;
e t 17 EXCEPTING CERTAIN PLANS;
CREATING w l n d 18 NEW DUTIES FOR THE BOARD OF w l n d 18 PHARMACY.
SectionA 13-7-24new NMSAsection 1978of (beingChapter Laws59A, 2020,Article 22 NMSA d r e 22 Chapter1978 79, Section 1) is amendedenacted to read:
c e s k 23 "13-7-24."[NEW MATERIAL] CORONARY ARTERY CALCIUM SCREENING AND e a n b 24 CHOLESTEROL LIPID PANELS COVERAGE.-- u [ A.
[HEART]An CORONARYindividual ARTERYor CALCIUMgroup [SCAN]health einsurance apolicy, n.233915.1 bSHPAC/SB 24130 SCREENINGhealth ANDcare CHOLESTEROLplan LIPIDor PANELScertificate COVERAGE.--of uhealth [insurance A.that is delivered, issued for delivery or renewed in this state shall provide coverage for an eligible insured to receive a coronary artery calcium screening and low-density lipoprotein panels.
Group health coverage, including any form of .233081.2 self-insurance, offered, issued or renewed under the Health Care Purchasing Act shall provide coverage for eligible insureds to receive a [heart] coronary artery calcium [scan] screening and cholesterol lipid panels.
(1) be limited to the provision of a [heart] coronary artery calcium [scan] screening to an eligible insured at the discretion of a health care provider to be used as a clinical management tool;
(2) be provided every five years if an eligible insured has previously received a [heart] coronary artery calcium score of zero;
[and] (3) not be required for future [heart] coronary artery calcium [scans] screenings if an eligible insured receives a [heart] coronary artery calcium score e t 17 greater than zero;
and we lt n17 d 18 (4) not impose cost sharing on an eligible =w =l 19n ad l18 insured over the age of forty-nine, unless the eligible insured i= a= e19 r 20 has a strongfirst familydegree historyrelative ofwith coronarya arterymedical diseasehistory orof a ta ml mi 21a symptomse thatr are20 diagnosedmyocardial asinfarction coronarybefore artery disease by the dage rof eforty. 22 eligible insured's health care provider.
ca et sm km 2321 [C.C.
AtThe itsprovisions discretionof this section do not apply to d r e 22 short-term travel, accident-only or aslimited requiredor byspecified law,c ane s k 23 disease policies, plans or certificates of health insurance, e a n b 24 insurercatastrophic mayplans offeras ordefined refuseunder coverage42 forUSCA furtherSection cardiac18022(e) or u [ testinghigh-deductible orhealth proceduresplans forwith eligiblehealth insuredssavings basedaccounts uponuntil the.233915.1 .233081.2 - 2 - resultsSHPAC/SB of130 aan hearteligible arteryinsured's calciumdeductible scan.has been met, unless otherwise permitted by federal law.
D.] C.
The provisions of this section shall not apply to short-term travel, accident-only or limited or specified-disease policies, plans or certificates of health insurance, catastrophic plans as defined under 42 USCA Section 18022(e) or high-deductible health plans with health savings accounts until a covered person's deductible has been met, unless otherwise permitted by federal law.
[E.] D.
As used in this section:
[(1) "eligible insured" means an insured who:
(a) is a person between the ages of forty-five and sixty-five;
and (b) has an intermediate risk of developing coronary heart disease as determined by a health care provider based upon a score calculated from an evidence- based algorithm widely used in the medical community to assess e t 17 a person's ten-year cardiovascular disease risk, including a w l n d 18 score calculated using a pooled cohort equation;
= = 19 a l (2) "health care provider" means a physician, i a e r 20 physician assistant, nurse practitioner or other health care a t m m 21 professional authorized to furnish health care services within d r e 22 the scope of the professional's license;
and c e s k 23 (3) "heart] (1) "cholesterol lipid panels" e a n b 24 means blood tests that measure one or more of the following:
u [ (a) total cholesterol;
.233081.2 - 3 - (b) low-density lipoprotein cholesterol;
(c) high-density lipoprotein cholesterol;
(d) lipoprotein (a);
(e) triglycerides;
and (f) high-sensitivity c-reactive protein;
(2) "coronary artery calcium [scan] screening" means a computed tomography scan measuring coronary artery calcium for atherosclerosis and abnormal artery structure and function;
(3) "cost sharing" means deductibles, copayments or coinsurance;
and (4) "health care provider" means a physician, physician assistant, nurse practitioner or other health care professional authorized to furnish health care services within the scope of the professional's license." e t 17 SECTION 2.
A new section of the Health Care Purchasing w l n d 18 Act is enacted to read:
= = 19 a l "[NEW MATERIAL] COVERAGE FOR MEDICATIONS USED FOR THE i a e r 20 TREATMENT OF CHOLESTEROL DISORDER.-- a t m m 21 A.
Group health coverage, including any form of d r e 22 self-insurance, offered, issued or renewed under the Health c e s k 23 Care Purchasing Act that provides coverage for cholesterol- e a n b 24 lowering medications shall not impose cost sharing on generic u [ medications.
.233081.2 - 4 - B.
If generic medications fail to lower cholesterol in the blood to below sixty milligrams per deciliter or generate adverse reactions not tolerated by the patient, as determined by the prescribing health care provider, cost sharing shall not be imposed on second-line step therapy medications.
C.
The provisions of this section do not apply to excepted benefit plans as provided pursuant to the Short-Term Health Plan and Excepted Benefit Act, catastrophic plans as defined pursuant to 42 USCA Section 18022(e) or high-deductible health plans with health savings accounts until an eligible insured's deductible has been met, unless otherwise allowed pursuant to federal law.
Show all 200 changed lines (160 more)
For the purposes of this section, "cost sharing" means a copayment, coinsurance, a deductible or any other form of financial obligation of an enrollee other than a premium or e t 17 a share of a premium, or any combination of any of these w l n d 18 financial obligations, as defined by the terms of a group = = 19 a l health plan." i a e r 20 SECTION 3.
Section 27-2-12.31 NMSA 1978 (being Laws 2020, a t m m 21 Chapter 79, Section 2) is amended to read:
d r e 22 "27-2-12.31.
[HEART] CORONARY ARTERY CALCIUM [SCAN] c e s k 23 SCREENING AND CHOLESTEROL LIPID PANELS COVERAGE.-- e a n b 24 A.
In accordance with federal law, the secretary u [ shall adopt and promulgate rules that provide medical .233081.2 - 5 - assistance coverage for eligible enrollees to receive a [heart] coronary artery calcium [scan] screening and cholesterol lipid panels.
B.
Medical assistance coverage provided pursuant to this section shall:
(1) be limited to the provision of a [heart] coronary artery calcium [scan] screening to an eligible enrollee at the discretion of a health care provider to be used as a clinical management tool;
(2) be provided every five years if an eligible enrollee has previously received a [heart] coronary artery calcium score of zero;
[and] (3) not be required for future [heart] coronary artery calcium [scans] screenings if an eligible enrollee receives a [heart] coronary artery calcium score greater than zero;
and e t 17 (4) not impose cost sharing on an eligible w l n d 18 enrollee over the age of forty-nine, unless the eligible = = 19 a l enrollee has a strong family history of coronary artery disease i a e r 20 or symptoms that are diagnosed as coronary artery disease by a t m m 21 the eligible enrollee's health care provider.
d r e 22 [C.
At its discretion or as required by law, a c e s k 23 managed care organization providing medical assistance may e a n b 24 offer or refuse coverage for further cardiac testing or u [ procedures for eligible enrollees based upon the results of a .233081.2 - 6 - heart artery calcium scan.
D.] C.
The provisions of this section shall not apply to short-term travel, accident-only or limited or specified-disease policies, plans or certificates of health insurance, catastrophic plans as defined under 42 USCA Section 18022(e) or high-deductible health plans with health savings accounts until a covered person's deductible has been met, unless otherwise permitted by federal law.
[E.] D.
[(1)(1) "eligible"cholesterol enrollee"lipid panels" means anblood enrolleetests who:that measure one or more of the following:
(a) istotal acholesterol; person between the ages of forty-five and sixty-five;
and (b) has an intermediate risk of developing coronary heart disease as determined by a health care provider based upon a score calculated from an evidence- e t 17 based algorithm widely used in the medical community to assess w l n d 18 a person's ten-year cardiovascular disease risk, including a = = 19 a l score calculated using a pooled cohort equation;
i a e r 20 (2) "health care provider" means a physician, a t m m 21 physician assistant, nurse practitioner or other health care d r e 22 professional authorized to furnish health care services within c e s k 23 the scope of the professional's license;
and e a n b 24 (3) "heart] (1) "cholesterol lipid panels" u [ means blood tests that measure one or more of the following:
.233081.2 - 7 - (a) total cholesterol;
(2) "coronary artery calcium [scan] screening" means a computed tomography scan measuring coronary artery calcium for atherosclerosis and abnormal artery structure and function;
(3) "cost sharing" means deductibles, e t 17 copayments or coinsurance;
and w l n d 18 (4) "health care provider" means a physician, = = 19 physician assistant, nurse practitioner or other health care a l i a e r 20 professional authorized to furnish health care services within ea t 17m m 21 the scope of the professional's license." wd lr ne d22 18 SECTION 4.2.
A new section of Chapter 59A, Article 22 NMSA =c =e 19s ak l23 1978 is enacted to read:
ie a en rb 2024 "[NEW MATERIAL] COVERAGE FOR MEDICATIONS USED FOR THE au t[ m m 21 TREATMENT OF CHOLESTEROL DISORDER.-- d.233915.1 r- e3 22- SHPAC/SB 130 A.
An individual or group health insurance policy, c e s k 23 health care plan or certificate of health insurance that is e a n b 24 delivered, issued for delivery or renewed in this state that u [ provides coverage for cholesterol-lowering medications shall .233081.2 - 8 - not impose cost sharing on generic medications.
IfCost generic medications fail to lower cholesterol in the blood to below sixty milligrams per deciliter or generate adverse reactions not tolerated by the patient, as determined by the prescribing health care provider, cost sharing shall not be imposed on second-line step therapy medication.medications if generic medications:
(1) fail to lower low-density lipoprotein in the blood to below sixty milligrams per deciliter or another level deemed appropriate by a patient's health care provider;
or (2) generate adverse reactions not tolerated by the patient, as determined by the prescribing health care provider.
The provisions of this section do not apply to excepted benefit plans as provided pursuant to the Short-Term e t 17 Health Plan and Excepted Benefit Act, catastrophic plans as w l n d 18 defined pursuant to 42 USCA Section 18022(e) or high-deductible = = 19 health plans with health savings accounts until an eligible a l i a e r 20 insured's deductible has been met, unless otherwise allowed a t m m 21 pursuant to federal law.
d r e 22 D.
For the purposes of this section, "cost sharing" c e s k 23 means a copayment, coinsurance, a deductible or any other form e ta 17n b 24 of financial obligation of the enrollee other than a premium or wu l[ n d 18 a share of a premium, or any combination of any of these =.233915.1 =- 194 a- lSHPAC/SB 130 financial obligations, as defined by the terms of an individual i a e r 20 or group health insurance policy, health care plan or a t m m 21 certificate of health insurance." d r e 22 SECTION 5.3.
Section 59A-23-7.16 NMSA 1978 (being Laws c e s k 23 2020, Chapter 79, Section 3) is amended to read:
e a n b 24 "59A-23-7.16.
[HEART] CORONARY ARTERY CALCIUM [SCAN] u [ SCREENING AND CHOLESTEROL LIPID PANELS COVERAGE.-- .233081.2 - 9 - A.
(1) be limited to the provision of a [heart] e t 17 coronary artery calcium [scan] screening to an eligible insured w l n d 18 at the discretion of a health care provider to be used as a = = 19 clinical management tool;
a l i a e r 20 (2) be provided every five years if an a t m m 21 eligible insured has previously received a [heart] coronary d r e 22 artery calcium score of zero;
[and] c e s k 23 (3) not be required for future [heart] e ta 17n b 24 coronary artery calcium [scans] screenings if an eligible wu l[ n d 18 insured receives a [heart] coronary artery calcium score =.233915.1 =- 195 a- lSHPAC/SB 130 greater than zero;
and i a e r 20 (4) not impose cost sharing on an eligible a t m m 21 insured over the age of forty-nine, unless the eligible insured dhas ra efirst 22degree hasrelative with a strongmedical family history of coronarya arterymyocardial diseaseinfarction orbefore c e s k 23 symptoms that are diagnosed as coronary artery disease by the eage aof nforty. b 24 eligible insured's health care provider.
u [ [C.
At its discretion or as required by law, an .233081.2 - 10 - insurer may offer or refuse coverage for further cardiac testing or procedures for eligible insureds based upon the results of a heart artery calcium scan.
e t 17 [E.] D.
w l n d 18 [(1) "eligible insured" means an insured who:
= = 19 (a) is a person between the ages of a l i a e r 20 forty-five and sixty-five;
and a t m m 21 (b) has an intermediate risk of d r e 22 developing coronary heart disease as determined by a health c e ts 17k 23 care provider based upon a score calculated from an evidence- we la n db 1824 based algorithm widely used in the medical community to assess =u =[ 19 a l a person's ten-year cardiovascular disease risk, including a i.233915.1 a- e6 r- 20SHPAC/SB 130 score calculated using a pooled cohort equation;
a t m m 21 (2) "health care provider" means a physician, d r e 22 physician assistant, nurse practitioner or other health care c e s k 23 professional authorized to furnish health care services within e a n b 24 the scope of the professional's license;
and u [ (3) "heart] (1) "cholesterol lipid panels" .233081.2 - 11 - means blood tests that measure one or more of the following:
(2) "coronary artery calcium [scan] screening" means a computed tomography scan measuring coronary artery e t 17 calcium for atherosclerosis and abnormal artery structure and w l n d 18 function;
= = 19 (3) "cost sharing" means deductibles, a l i a e r 20 copayments or coinsurance;
and a t m m 21 (4) "health care provider" means a physician, d r e 22 physician assistant, nurse practitioner or other health care c e ts 17k 23 professional authorized to furnish health care services within we la n db 1824 the scope of the professional's license." =u =[ 19 a l SECTION 6.4.
A new section of Chapter 59A, Article 23 NMSA i.233915.1 a- e7 r- 20SHPAC/SB 130 1978 is enacted to read:
a t m m 21 "[NEW MATERIAL] COVERAGE FOR MEDICATIONS USED FOR THE d r e 22 TREATMENT OF CHOLESTEROL DISORDER.-- c e s k 23 A.
A group or blanket health insurance policy, e a n b 24 health care plan or certificate of health insurance that is u [ delivered, issued for delivery or renewed in this state that .233081.2 - 12 - provides coverage for cholesterol-lowering medications shall not impose cost sharing on generic medications.
IfCost generic medications fail to lower cholesterol in the blood to below sixty milligrams per deciliter or generate adverse reactions not tolerated by the patient, as determined by the prescribing health care provider, cost sharing shall not be imposed on second-line step therapy medications.medications if generic medications:
C.(1) fail to lower low-density lipoprotein in the blood to below sixty milligrams per deciliter or another level deemed appropriate by a patient's health care provider;
Theor provisions(2) ofgenerate thisadverse sectionreactions do not applytolerated toby exceptedthe benefitpatient, plans as provideddetermined pursuantby to the Short-Termprescribing Health Plan and Excepted Benefit Act, catastrophic plans as defined pursuant to 42 USCA Section 18022(e) or high-deductible health planscare withe healtht savings17 accountsprovider. until an eligible insured's deductible has been met, unless otherwise allowed pursuant to federal law.
D.w l n d 18 C.
ForThe theprovisions purposes of this section,section "costdo sharing"not eapply tto 17 means a copayment, coinsurance, a deductible or any other form w l n d 18 of financial obligation of an insured other than a premium or a = = 19 aexcepted lbenefit shareplans ofas aprovided premium,pursuant orto anythe combinationShort-Term ofa anyl of these i a e r 20 financialHealth obligations,Plan asand definedExcepted byBenefit theAct, termscatastrophic ofplans aas group or a t m m 21 blanketdefined healthpursuant insuranceto policy,42 healthUSCA careSection plan18022(e) or high-deductible d r e 22 certificatehealth ofplans with health insurance."savings accounts until an eligible c e s k 23 SECTIONinsured's 7.deductible has been met, unless otherwise allowed e a n b 24 pursuant to federal law.
Sectionu 59A-46-50.5[ NMSAD. 1978 (being Laws e a n b 24 2020, Chapter 79, Section 4) is amended to read:
uFor [the "59A-46-50.5.purposes of this section, "cost sharing" .233915.1 - 8 - SHPAC/SB 130 means a copayment, coinsurance, a deductible or any other form of financial obligation of an insured other than a premium or a share of a premium, or any combination of any of these financial obligations, as defined by the terms of a group or blanket health insurance policy, health care plan or certificate of health insurance." SECTION 5.
[HEART]Section CORONARY59A-46-50.5 ARTERYNMSA CALCIUM1978 [SCAN](being .233081.2Laws -2020, 13Chapter -79, SCREENINGSection AND4) CHOLESTEROLis LIPIDamended PANELSto COVERAGE.--read: A.
"59A-46-50.5.
[HEART] CORONARY ARTERY CALCIUM [SCAN] SCREENING AND CHOLESTEROL LIPID PANELS COVERAGE.-- A.
e t 17 B.
Coverage provided pursuant to this section w l n d 18 shall:
= = 19 (1) be limited to the provision of a [heart] a l i a e r 20 coronary artery calcium [scan] screening to an eligible a t m m 21 enrollee at the discretion of a health care provider to be used d r e 22 as a clinical management tool;
c e s k 23 (2) be provided every five years if an e a n b 24 eligible enrollee has previously received a [heart] coronary u [ artery calcium score of zero;
[and] e.233915.1 t- 179 - SHPAC/SB 130 (3) not be required for future [heart] w l n d 18 coronary artery calcium [scans] screenings if an eligible = = 19 a l enrollee receives a [heart] coronary artery calcium score i a e r 20 greater than zero;
and a t m m 21 (4) not impose cost sharing on an eligible d r e 22 enrollee over the age of forty-nine, unless the eligible cenrollee ehas sa kfirst 23degree enrolleerelative haswith a strongmedical family history of coronary artery disease e a nmyocardial binfarction 24before or symptoms that are diagnosed as coronary artery disease by u [ the eligibleage enrollee'sof healthforty. care provider.
.233081.2 - 14 - [C.
The provisions of this section do not apply to short-term travel, accident-only or limited or specified- disease policies, plans or certificates of health insurance, catastrophic plans as defined under 42 USCA Section 18022(e) or e t 17 high-deductible health plans with health savings accounts until w l n d 18 a covered person's deductible has been met, unless otherwise = = 19 permitted by federal law.
a l i a e r 20 [E.] D.
a t m m 21 [(1) "eligible enrollee" means an enrollee d r e 22 who:
c e s k 23 (a) is a person between the ages of e a n b 24 forty-five and sixty-five;
and eu t[ 17 (b) has an intermediate risk of w.233915.1 l- n10 d- 18SHPAC/SB 130 developing coronary heart disease as determined by a health = = 19 a l care provider based upon a score calculated from an evidence- i a e r 20 based algorithm widely used in the medical community to assess a t m m 21 a person's ten-year cardiovascular disease risk, including a d r e 22 score calculated using a pooled cohort equation;
c e s k 23 (2) "health care provider" means a physician, e a n b 24 physician assistant, nurse practitioner or other health care u [ professional authorized to furnish health care services within .233081.2 - 15 - the scope of the professional's license;
e t 17 (e) triglycerides;
and w l n d 18 (f) high-sensitivity c-reactive protein;
= = 19 (2) "coronary artery calcium [scan] screening" a l i a e r 20 means a computed tomography scan measuring coronary artery a t m m 21 calcium for atherosclerosis and abnormal artery structure and d r e 22 function;
c e s k 23 (3) "cost sharing" means deductibles, e a n b 24 copayments or coinsurance;
and eu t[ 17 (4) "health care provider" means a physician, w.233915.1 l- n11 d- 18SHPAC/SB 130 physician assistant, nurse practitioner or other health care = = 19 a l professional authorized to furnish health care services within i a e r 20 the scope of the professional's license." a t m m 21 SECTION 8.6.
A new section of the Health Maintenance d r e 22 Organization Law is enacted to read:
c e s k 23 "[NEW MATERIAL] COVERAGE FOR MEDICATIONS USED FOR THE e a n b 24 TREATMENT OF CHOLESTEROL DISORDER.-- u [ A.
An individual or group health maintenance .233081.2 - 16 - organization contract that is delivered, issued for delivery or renewed in this state that provides coverage for cholesterol- lowering medications shall not impose cost sharing on generic medications.
IfCost generic medications fail to lower cholesterol in the blood to below sixty milligrams per deciliter or generate adverse reactions not tolerated by the patient, as determined by the prescribing health care provider, cost sharing shall not be imposed on second-line step therapy medications.medications if generic medications:
C.(1) fail to lower low-density lipoprotein in the blood to below sixty milligrams per deciliter or another e t 17 level deemed appropriate by a patient's health care provider;
Thew provisionsl ofn thisd section18 door not= apply= to19 excepted(2) benefitgenerate plansadverse asreactions providednot pursuanttolerated toa thel Short-Termi Healtha Plane andr Excepted20 Benefitby Act,the catastrophicpatient, plans as defineddetermined pursuantby tothe 42prescribing USCA Section 18022(e) or high-deductible health planscare witha health savings accounts until an eligible insured's deductible has been met, unless otherwise allowed e t 17m pursuantm to21 federalprovider. law.
wd lr ne d22 18C. D.
ForThe theprovisions purposes of this section,section "costdo sharing"not =apply =to 19c ae ls meansk a23 copayment,excepted coinsurance,benefit aplans deductibleas orprovided anypursuant otherto formthe iShort-Term a e ra 20n ofb financial24 obligationHealth ofPlan anand enrolleeExcepted otherBenefit thanAct, acatastrophic premiumplans oras au t[ mdefined mpursuant 21to a42 shareUSCA ofSection a18022(e) premium, or anyhigh-deductible combination.233915.1 of- any12 of- theseSHPAC/SB d130 rhealth eplans 22with financialhealth obligations,savings asaccounts defineduntil by the terms of an individualenrollee's cdeductible ehas sbeen kmet, 23unless orotherwise groupallowed healthpursuant maintenanceto organizationfederal contract."law. e a n b 24 SECTION 9.
SectionD. 59A-47-45.7 NMSA 1978 (being Laws u [ 2020, Chapter 79, Section 5) is amended to read:
.233081.2For -the 17purposes -of "59A-47-45.7.this section, "cost sharing" means a copayment, coinsurance, a deductible or any other form of financial obligation of an enrollee other than a premium or a share of a premium, or any combination of any of these financial obligations, as defined by the terms of an individual or group health maintenance organization contract." SECTION 7.
Section 59A-47-45.7 NMSA 1978 (being Laws 2020, Chapter 79, Section 5) is amended to read:
"59A-47-45.7.
A group health care plan, other than a small group health care plan, that is delivered, issued for delivery or renewed in this state shall provide coverage for eligible e t 17 subscribers to receive a [heart] coronary artery calcium [scan] w l n d 18 screening and cholesterol lipid panels.
= = 19 B.
Coverage provided pursuant to this section a l i a e r 20 shall:
a t m m 21 (1) be limited to the provision of a [heart] d r e 22 coronary artery calcium [scan] screening to an eligible c e s k 23 subscriber at the discretion of a health care provider to be e a n b 24 used as a clinical management tool;
u [ (2) be provided every five years if an .233915.1 - 13 - SHPAC/SB 130 eligible subscriber has previously received a [heart] coronary artery calcium score of zero;
[and] e t 17 (3) not be required for future [heart] w l n d 18 coronary artery calcium [scans] screenings if an eligible = = 19 a l subscriber receives a [heart] coronary artery calcium score i a e r 20 greater than zero;
and a t m m 21 (4) not impose cost sharing on an eligible d r e 22 subscriber over the age of forty-nine, unless the eligible csubscriber ehas sa kfirst 23degree subscriberrelative haswith a strongmedical family history of coronary artery e a nmyocardial binfarction 24before disease or symptoms that are diagnosed as coronary artery u [ disease by the eligibleage subscriber'sof healthforty. care provider.
.233081.2 - 18 - [C.
The provisions of this section do not apply to short-term travel, accident-only or limited or specified- e t 17 disease policies, plans or certificates of health insurance, w l n d 18 catastrophic plans as defined under 42 USCA Section 18022(e) or = = 19 high-deductible health plans with health savings accounts until a l i a e r 20 a covered person's deductible has been met, unless otherwise a t m m 21 permitted by federal law.
d r e 22 [E.] D.
c e s k 23 [(1) "eligible subscriber" means a subscriber e a n b 24 who:
u [ (a) is a person between the ages of .233915.1 - 14 - SHPAC/SB 130 forty-five and sixty-five;
and e t 17 (b) has an intermediate risk of w l n d 18 developing coronary heart disease as determined by a health = = 19 a l care provider based upon a score calculated from an evidence- i a e r 20 based algorithm widely used in the medical community to assess a t m m 21 a person's ten-year cardiovascular disease risk, including a d r e 22 score calculated using a pooled cohort equation;
c e s k 23 (2) "health care provider" means a physician, e a n b 24 physician assistant, nurse practitioner or other health care u [ professional authorized to furnish health care services within .233081.2 - 19 - the scope of the professional's license;
(c) high-density lipoprotein e t 17 cholesterol;
w l n d 18 (d) lipoprotein (a);
= = 19 (e) triglycerides;
and a l i a e r 20 (f) high-sensitivity c-reactive protein;
a t m m 21 (2) "coronary artery calcium [scan] screening" d r e 22 means a computed tomography scan measuring coronary artery c e s k 23 calcium for atherosclerosis and abnormal artery structure and e a n b 24 function;
u [ (3) "cost sharing" means deductibles, .233915.1 - 15 - SHPAC/SB 130 copayments or coinsurance;
and e t 17 (4) "health care provider" means a physician, w l n d 18 physician assistant, nurse practitioner or other health care = = 19 a l professional authorized to furnish health care services within i a e r 20 the scope of the professional's license." a t m m 21 SECTION 10.8.
A new section of the Nonprofit Health Care d r e 22 Plan Law is enacted to read:
c e s k 23 "[NEW MATERIAL] COVERAGE FOR MEDICATIONS USED FOR THE e a n b 24 TREATMENT OF CHOLESTEROL DISORDER.-- u [ A.
An individual or group health care plan that is .233081.2 - 20 - delivered, issued for delivery or renewed in this state that provides coverage for cholesterol-lowering medications shall not impose cost sharing on generic medications.
IfCost generic medications fail to lower cholesterol in the blood to below sixty milligrams per deciliter or generate adverse reactions not tolerated by the patient, as determined by the prescribing health care provider, cost sharing shall not be imposed on second-line step therapy medications.medications if generic medications:
C.(1) fail to lower low-density lipoprotein in e t 17 the blood to below sixty milligrams per deciliter or another w l n d 18 level deemed appropriate by a patient's health care provider;
The= provisions= of19 thisor sectiona dol noti applya toe exceptedr benefit20 plans(2) asgenerate providedadverse pursuantreactions tonot thetolerated Short-Terma Healtht Planm andm Excepted21 Benefitby Act,the catastrophicpatient, plans as defineddetermined pursuantby tothe 42prescribing USCA Section 18022(e) or high-deductible health planscare withd healthr savingse accounts22 untilprovider. an eligible insured's deductible has been met, unless otherwise allowed pursuant to federal law.
c e ts 17k D.23 C.
ForThe theprovisions purposes of this section,section "costdo sharing"not wapply lto ne da 18n meansb a24 copayment,excepted coinsurance,benefit aplans deductibleas orprovided anypursuant otherto formthe =Short-Term =u 19[ aHealth lPlan ofand financialExcepted obligationBenefit ofAct, acatastrophic subscriberplans otheras than.233915.1 a- premium16 or- iSHPAC/SB a130 edefined rpursuant 20to a42 shareUSCA ofSection a18022(e) premium, or anyhigh-deductible combinationhealth ofplans anywith ofhealth thesesavings aaccounts tuntil ma msubscriber's 21deductible financialhas obligations,been asmet, definedunless byotherwise theallowed termspursuant ofto anfederal individuallaw. d r e 22 or group health care plan." c e s k 23 SECTION 11.
SectionD. 61-11-6 NMSA 1978 (being Laws 1969, e a n b 24 Chapter 29, Section 5, as amended) is amended to read:
uFor [the "61-11-6.purposes of this section, "cost sharing" means a copayment, coinsurance, a deductible or any other form of financial obligation of a subscriber other than a premium or a share of a premium, or any combination of any of these financial obligations, as defined by the terms of an individual or group health care plan." SECTION 9.
POWERSSection AND61-11-6 DUTIESNMSA OF1978 BOARD.--(being .233081.2Laws -1969, 21Chapter -29, A.Section 5, as amended) is amended to read:
"61-11-6.
POWERS AND DUTIES OF BOARD.-- A.
(1) promulgate rules in accordance with the provisions of the State Rules Act to carry out the provisions e t 17 of the Pharmacy Act in accordance with the provisions of the w l n d 18 Uniform Licensing Act;
= = 19 (2) provide for examinations of applicants for a l i a e r 20 licensure as pharmacists;
a t m m 21 (3) provide for the issuance and renewal of d r e 22 licenses for pharmacists;
c e s k 23 (4) require and establish criteria for e a n b 24 continuing education as a condition of renewal of licensure for u [ pharmacists;
.233915.1 - 17 - SHPAC/SB 130 (5) provide for the issuance and renewal of licenses for pharmacist interns and for their training, supervision and discipline;
(6) provide for the licensing of retail e t 17 pharmacies, nonresident pharmacies, wholesale drug w l n d 18 distributors, drug manufacturers, hospital pharmacies, nursing = = 19 a l home drug facilities, industrial and public health clinics and i a e r 20 all places where dangerous drugs are stored, distributed, a t m m 21 dispensed or administered and provide for the inspection of the d r e 22 facilities and activities;
c e s k 23 (7) enforce the provisions of all laws of the e a n b 24 state pertaining to the practice of pharmacy and the u [ manufacture, production, sale or distribution of drugs or .233081.2 - 22 - cosmetics and their standards of strength and purity;
(8) conduct hearings upon charges relating to the discipline of a registrant or licensee or the denial, e t 17 suspension or revocation of a registration or a license in w l n d 18 accordance with the Uniform Licensing Act;
= = 19 (9) cause the prosecution of any person a l i a e r 20 violating the Pharmacy Act, the New Mexico Drug, Device and a t m m 21 Cosmetic Act or the Controlled Substances Act;
d r e 22 (10) keep a record of all proceedings of the c e s k 23 board;
e a n b 24 (11) make an annual report to the governor;
u [ (12) appoint and employ, in the board's .233915.1 - 18 - SHPAC/SB 130 discretion, a qualified person who is not a member of the board to serve as executive director and define the executive director's duties and responsibilities;
except that the power to deny, revoke or suspend any license or registration e t 17 authorized by the Pharmacy Act shall not be delegated by the w l n d 18 board;
= = 19 a l (13) appoint and employ inspectors necessary i a e r 20 to enforce the provisions of all acts under the administration a t m m 21 of the board, which inspectors shall be pharmacists and have d r e 22 all the powers and duties of peace officers;
c e s k 23 (14) provide for other qualified employees e a n b 24 necessary to carry out the provisions of the Pharmacy Act;
u [ (15) have the authority to employ a competent .233081.2 - 23 - attorney to give advice and counsel in regard to any matter connected with the duties of the board, to represent the board in any legal proceedings and to aid in the enforcement of the e t 17 laws in relation to the pharmacy profession and to fix the w l n d 18 compensation to be paid to the attorney;
provided, however, = = 19 that the attorney shall be compensated from the money of the a l i a e r 20 board, including that provided for in Section 61-11-19 NMSA a t m m 21 1978;
d r e 22 (16) register and regulate qualifications, c e s k 23 training and permissible activities of pharmacy technicians;
e a n b 24 (17) provide a registry of all persons u [ licensed as pharmacists or pharmacist interns in the state;
.233915.1 - 19 - SHPAC/SB 130 (18) promulgate rules that prescribe the activities and duties of pharmacy owners and pharmacists in the provision of pharmaceutical care, emergency prescription dispensing, drug regimen review and patient counseling in each e t 17 practice setting;
w l n d 18 (19) promulgate, after approval by the New = = 19 a l Mexico medical board and the board of nursing, rules and i a e r 20 protocols for the prescribing of dangerous drug therapy, a t m m 21 including vaccines and immunizations, and the appropriate d r e 22 notification of the primary or appropriate physician of the c e s k 23 person receiving the dangerous drug therapy;
[and] e a n b 24 (20) have the authority to authorize emergency u [ prescription dispensing;
and .233081.2 - 24 - (21) promulgate rules and establish protocols for the assessment of cardiovascular risk and the prescribing of lipid-lowering or cardiovascular plaque-reducing dangerous e t 17 drug therapies based on a person's level of cardiovascular risk w l n d 18 in accordance with standards of care.
= = 19 B.
a l i a e r 20 (1) delegate its authority to the executive a t m m 21 director to issue temporary licenses as provided in Section d r e 22 61-11-14 NMSA 1978;
c e s k 23 (2) provide by rule for the electronic e a n b 24 transmission of prescriptions;
and u [ (3) delegate its authority to the executive .233915.1 - 20 - SHPAC/SB 130 director to authorize emergency prescription dispensing procedures during civil or public health emergencies." SECTION 12.10.
APPLICABILITY.--The provisions of this act apply to group health insurance policies, health care plans or e t 17 certificates of health insurance that are delivered, issued for w l n d 18 delivery or renewed in this state on or after January 1, 2027.
= = 19 a l SECTION 13.11.
EFFECTIVE DATE.--The effective date of the i a e r 20 provisions of this act is January 1, 2027.
- 21 - 11 13 15 e t 17 w l n d 18 = = 19 a l i a e r 20 a t m m 21 - 25 - d r e 22 c e s k 23 e a n b 24 u [ .233081.2.233915.1
Show all 200 changed rows (160 more)
View plain text versions (2)
- Substitute PA substitute Current pdf
- Introduced introduced version pdf
Action History
-
action postponed indefinitely
-
DO NOT PASS, replaced with committee substitute
-
Sent to Senate Health and Public Affairs Committee
-
special
-
germane
-
Sent to Senate Committees' Committee & Senate Health and Public Affairs Committee & Senate Tax, Business and Transportation Committee
Sponsors
- Martin Hickey · Primary
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 0 co-sponsors · 111 not signed on
Sponsors (1)
- Martin Hickey Democrat
Co-sponsors (0)
None.
Not signed on (111)
111 members have not signed on to this bill.
Show all 111 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Subjects
Frequently asked questions
- Who sponsors SB 130?
- SB 130 is sponsored by Martin Hickey (Democrat).
- What is the current status of SB 130?
- This bill is in committee in the Senate. Introduced January 23, 2026. It must pass committee before a floor vote.
- Where can I track SB 130?
- Track SB 130 free on One Click Politics — get push/email alerts when it moves.
Make your voice heard on SB 130
Find the representatives who decide this bill and tell them where you stand — for yourself, or mobilize your whole list in one click with One Click Politics advocacy software.
Stay ahead of SB 130
Last checked for changes 2 months ago · updated continuously
One Click Politics tracks every bill in Congress and all 50 states.
Track this bill →