Mental Health Parity

Mental Health Parity and Access

State and federal Mental Health Parity Law requires insurance coverage for mental health conditions, including substance use disorders, to be no more restrictive than insurance coverage for other medical conditions.

Helpful Guides for Understanding Mental Health / Substance Use Disorder Parity

1. Quick Guide to Mental Health Parity
2. Consumer Guide to Mental Health Parity
3. Provider Guide to Mental Health Parity
4. Provider Brochure
5. Insurer Mental Health Parity Frequently Asked Questions

Data Call Pursuant to Senate Bill 317: Applying Cost-Sharing Waivers to Behavioral Health Services

Senate Bill 317 (SB 317), titled “No Behavioral Health Cost Sharing,” was signed into law by Governor Michelle Lujan Grisham on April 8, 2021, and became effective January 1, 2022. Among other advancements, SB 317 prohibits cost sharing for behavioral health (BH) services covered by any health care plan “delivered, issued for delivery or renewed in New Mexico” pursuant to NMSA 1978, Sections 59A-22-57, 59A23-16, 59A46-57, and 59A-47-51. Subsequently, the 2025 Legislature passed Senate Bill 120 (SB 120) which eliminated the expiration date of December 31, 2026, for the BH cost sharing waiver statutes that were enacted in SB 317.

The SB 317 Data Call Notice and attached templates listed below are being submitted by the New Mexico Office of Superintendent of Insurance (OSI) in accordance with the Section 59A-2-17 and SB 317 reporting requirements, using the following data call tools, due Monday, October 13, 2025.

Utilize the templates listed below for this SB 317 Data Call, updated 9/15/25.

• SB 317 Data Call Notice (Informational only)
• SB 317 Self-Attestation Tool (Insurers who had covered lives in the NM commercial/self-funded market in 2025, as specified in the law, required to complete)
• SB 317 Data Collection and Impact Report (Insurers who had covered lives in the NM commercial/self-funded market starting in 2022, as specified in the law, required to complete)

Mental Health and Substance Use Disorder (MH/SUD) Parity Compliance Filings

The templates required to be submitted by insurers for each compliance filing are listed below, by year. Note: Updated templates will be made available on this page at least 2 months prior to the submission due date.

Confidentiality of Mental Health/Substance Use Disorder (MH/SUD) Parity Raw Data Related Submissions: The data submitted pursuant to the mental health parity requirements will be deemed confidential pursuant to NMSA 1978, Sections 59A-2-12(B). OSI reserves any rights or remedies that OSI may have to use this data under the Insurance Code.

Note: The above confidentiality statement refers to data submitted via Dropbox. The information submitted to OSI via the System for Electronic Rates and Forms Filing (SERFF) remains subject to the SERFF confidentiality standards and procedures. However, OSI reserves any rights or remedies that OSI may have to use this data under the Insurance Code.

2026 MH/SUD Parity Filings – Deadlines and Templates:

1. MH/SUD Parity Provider Network/Reimbursement (Due January 15)

(Changed from 2025 “Network Adequacy and Provider Reimbursement”, previously due March 1)

Utilize the templates listed below for this filing, updated 11/4/25.

1. Provider Network/Reimbursement Additional Guidance – Informational only
2. Provider Network/Reimbursement Self-Attestation Tool – Insurers required to complete
3. Provider Network/Reimbursement NQTL Comparative Analyses Template – Insurers required to complete
4. Provider INN Rates/Credentialing Template – Insurers required to complete
5. Provider Network/Reimbursement Raw Data File Layouts – Insurers required to submit via individual secure Dropbox
6. Provider Network/Reimbursement Coversheet for Raw Data – Insurers required to complete

2. MH/SUD Parity Claims and Utilization Management (UM) Compliance Review (Due April 30)

(Changed from 2025 “Utilization Management – Phase 1”, previously due April 30)

The updated templates for this filing will be posted here at least 2 months before due date and will include:

1. Claims and UM Compliance Review Additional Guidance – Informational only
2. Claims and UM Self-Attestation Tool – insurers required to complete
3. Out-of-Network Utilization – insurers required to complete
4. Claims and UM NQTL Comparative Analyses – insurers required to complete
5. Claims and UM Raw Data File Layouts – insurers required to submit via individual secure Dropbox
6. Claims and UM Coversheet for Raw Data – insurers required to complete
7. High-Deductible Health Plan (HDHP) Plans Listing (new template in development to replace information previously collected in the Self-Attestation Tool) – insurers required to complete
8. Prescription Drug Comparative Formulary Data (new template in development in place of requesting full formulary) – insurers required to complete

3. MH/SUD Parity Claims and UM File Audit (Due September 1)

(Changed from 2025 “Utilization Management – Phase 2”, previously due October 31)

The updated templates for this filing will be posted here at least 2 months before due date and will include:

1. Claims and UM File Audit Additional Guidance – Informational only
2. Coversheet for Claim and UM Audits – insurers required to complete
3. Claim and UM record submissions – OSI will send insurers the list of member IDs to be audited by August 1.  Insurers will then be required to submit records via individual secure Dropbox

Senate Bill 273

New Mexico passed its own mental health parity and access law in 2023:

2023 Mental Health Access Law

Please contact the Mental Health Parity Team at OSI.MentalHealthParity@osi.nm.gov with any questions.