Summary:

 Senate Bill297 (SB297) requires the Health Care Authority to conduct regional commercial insurance market assessments and requires increased Medicaid reimbursement for health care services. 

Legislation Overview:

 Senate Bill297 (SB297) provides a new Section of the Public Assistance Act that would require by July 1, 2026 and every two years thereafter, the Authority shall conduct a market assessment to determine the regional average commercial insurance reimbursement rate for all health care services provided in Arizona, Colorado, Utah, Oklahoma and Texas that are covered by the New Mexico Medicaid program.
The Medicaid reimbursement rate for all health care services that are covered by the New Mexico Medicaid program shall be the greater of: (1)  two hundred percent of the Medicare reimbursement rate for the equivalent service; or (2)  the regional average commercial insurance reimbursement rate for the service.
Using the Medicaid reimbursement rate for each health care service as of July 1, 2024 as a baseline for comparison, all health care entities that receive increases in Medicaid reimbursement pursuant to this Section shall ensure that at least seventy-five percent of the increase in reimbursement revenue is used for: increased compensation for providers and staff, and to hire more health care workers.
The term "health care entity" means an entity, other than an individual, that is licensed to provide any form of health care in the state, including a hospital, clinic, hospice agency, home health agency, long-term care agency, pharmacy, group medical practice, medical home or any similar entity.