Bill > SB152

This bill, titled the "Health Security Act," aims to establish a comprehensive health care coverage program for all New Mexicans by combining public and private funding, controlling rising healthcare costs, and improving overall health outcomes. It creates a Health Care Commission, composed of fifteen members appointed through a nominating committee, to oversee the design and administration of the health security plan. The act defines various terms related to healthcare, including "beneficiary" (an eligible person), "health care" (provider and facility services), and "health security plan" (the program administered by the commission). The commission is tasked with numerous duties, such as developing a transition plan, applying for federal waivers, educating the public, establishing budgets, and collecting health data. It also outlines provisions for beneficiary rights, including claims review, appeals, and grievance procedures, and prohibits discrimination by healthcare providers. The bill details payment mechanisms for providers and facilities, copayment requirements for beneficiaries, and rules for obtaining a health resource certificate for major capital expenditures. Furthermore, it mandates fiscal and actuarial reviews, audits, and the establishment of an information technology system. The act also addresses the transfer of health insurance exchange functions to the commission and sets forth conditions for eligibility, exclusions, and the transition period for existing benefits. Finally, it includes an appropriation to the legislative finance committee for a fiscal analysis of the plan.