Summary:

 Senate Bill 450 (SB 450) enacts the Corporate Practice of Medicine Act, provides definitions, details prohibitions pertaining to certain health care centers, and allows for civil action by an individual or by the Attorney General on behalf of the state.  

Legislation Overview:

 Senate Bill 450 (SB 450) enacts the Corporate Practice of Medicine Act (Act). Definitions are provided as follows:

A. "federally qualified health center" means a health facility that the United States Department of Health and Human Services has deemed to qualify for federal funds as a federally qualified health center; 

B. "health care entity" means a person that provides or supports the provision of health care services to patients in New Mexico, including a hospital, health care provider, in-state or out-of-state telemedicine provider, health care staffing company, health care provider organization, health care facility, management services organization or organization of health care providers or facilities; 

C. "health care facility" means a hospital or other facility licensed by the Health Care Authority (Authority) to provide health care services in a health care setting; 

D. "health care provider" means a person certified, registered, licensed, or otherwise authorized to perform or provide health care services to individuals in the state; 

E. "health care services" means the care, prevention, diagnosis, treatment or relief of an illness, injury, disease or other medical, dental, mental, or behavioral health or substance use disorder condition;

F. "health care staffing company" means a person engaged in the business of providing, procuring for employment, or contracting health care personnel for a health care facility; 
G. "hospital" means a hospital licensed by the Authority;

H. "independent health care practice" means a health care provider organization entirely owned or controlled by one or more health care providers who are individuals and who provide health care services through the health care provider organization to patients in New Mexico; 

I. "long-term care facility" means a nursing home licensed by the health care authority to provide intermediate or skilled nursing care; 

J. "management services organization" means a person that contracts with a health care entity to perform or provide personnel to perform all or substantially all of the administrative or management services relating to supporting or facilitating the provision of health care services; and 

K. "telemedicine provider" means a provider who uses telecommunications and information technology to provide clinical health care from a distance to evaluate, diagnose and treat patients in real time or asynchronously.

Prohibitions regarding what a health care entity may do are provided, as follows:

A. A health care entity may not indirectly or directly interfere with, control, or otherwise direct the professional judgment or clinical decisions of a health care provider. 

B. A health care entity doing business in this state may not: (1) interfere with the professional judgment of a health care provider making health care decisions; or (2) exercise control over or do any of the following: (a) own or otherwise determine the content of patient medical records; (b) select, hire or fire health care providers, allied health staff or medical assistants based, in whole or in part, on clinical competency or proficiency; (c) set the parameters regarding contractual relationships with other health care providers or third-party payers; (e) make decisions regarding coding and billing procedures for patient care services; or (f) approve the selection of medical equipment and medical supplies for a health care provider.

A person who has suffered injury from an act or practice in violation of the Act may sue in district court. Whenever the Attorney General (AG) has reasonable belief that a person is engaging in or about to engage in an act or practice in violation of the Act and enforcement proceedings would be in the public interest, the AG may bring an action in the name of the state alleging violations of that Act. Powers of the AG and required procedures are detailed.

The effective date of the provisions of this act is July 1, 2025.



 

Current Law:

 There is no existing law comparable to the Corporate Practice of Medicine Act. New Mexico does have laws and regulations that protect patients and providers from some aspects of corporate medical centers, including HIPAA (The Health Insurance Portability and Accountability Act) of 1996 which protects the privacy of health information, and other laws that prohibit discrimination.