{"data":{"id":"us-nm/59a-46-50.5","jurisdiction":"us-nm","citation":"59A-46-50.5","heading":"Heart artery calcium scan coverage.","body":"A. A group health maintenance organization contract, other than a small group health maintenance organization contract, that is delivered, issued for delivery or renewed in this state shall provide coverage for eligible enrollees to receive a heart artery calcium scan.\nB. 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 carrier 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 do 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 59A - Insurance Code","ARTICLE 46 Health Maintenance Organizations"],"source_url":"https://nmonesource.com/nmos/nmsa-unanno/en/item/18562/index.do","current_through":"2026-07-01","vintage":"","retrieved_at":"2026-09-03T15:02:20Z","sha256":"f1ec4ab5a9d9db2e0283af629742f1d2a5d2ca81c5f21a3a57138fa819bad6ca","source_id":"us-nm","stale":false,"prev":"us-nm/59a-46-50.4","next":"us-nm/59a-46-51"},"notice":"GroundRules: Original legal text. Not legal advice."}