{"data":{"id":"us-nm/27-2-12.31","jurisdiction":"us-nm","citation":"27-2-12.31","heading":"Heart artery calcium scan coverage.","body":"A. In accordance with federal law, the secretary shall adopt and promulgate rules that provide medical assistance coverage for eligible enrollees to receive a heart artery calcium scan.\nB. Medical assistance coverage provided pursuant to this section shall:\n(1) be limited to the provision of a heart artery calcium scan to an eligible enrollee to be used as a clinical management tool;\n(2) be provided every five years if an eligible enrollee has previously received a heart artery calcium score of zero; and\n(3) not be required for future heart artery calcium scans if an eligible enrollee receives a heart artery calcium score greater than zero.\nC. At its discretion or as required by law, a managed care organization providing medical assistance may offer or refuse coverage for further cardiac testing or procedures for eligible enrollees based upon the results of a heart artery calcium scan.\nD. 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.\nE. As used in this section:\n(1) \"eligible enrollee\" means an enrollee who:\n(a) is a person between the ages of forty-five and sixty-five; and\n(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 a person's ten-year cardiovascular disease risk, including a score calculated using a pooled cohort equation;\n(2) \"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; and\n(3) \"heart artery calcium scan\" means a computed tomography scan measuring coronary artery calcium for atherosclerosis and abnormal artery structure and function.","path":["Chapter 27 - Public Assistance","ARTICLE 2 Public Assistance Act"],"source_url":"https://nmonesource.com/nmos/nmsa-unanno/en/item/18527/index.do","current_through":"2026-07-01","vintage":"","retrieved_at":"2026-09-03T15:02:19Z","sha256":"e0b645d57516e3aa08c1233b5e6050f0e6f1c1d6f7e04494ecba33eefe13e7c6","source_id":"us-nm","stale":false,"prev":"us-nm/27-2-12.30","next":"us-nm/27-2-12.32"},"notice":"GroundRules: Original legal text. Not legal advice."}