During the 2023 Legislative Session, Governor Michelle Lujan Grisham signed House Bill 131 specifying medical necessity and nondiscrimination standards that provide coverage for prosthetic and orthotic devices. During the 2026 Legislative Session, the governor expanded access by signing House Bill 38 to amend Sections 59A‑16‑21.4, 59A‑22‑62, 59A‑23‑32, 59A‑46‑72, and 59A‑47‑66 NMSA 1978. Legislative testimony in support of the bill established an intent to create specific health care rights for CRTs, including power-assisted mobility devices for athletic events. The Office of Superintendent of Insurance (OSI) works to ensure that health insurance carriers clearly communicate updates to insureds about changes in health insurance rights and benefits. The purpose of the bulletin is to clarify health insurance carriers’ obligations regarding medically necessary CRT devices, including requirements for replacement.

Coverage for CRT devices shall be based on an insured’s specific medical, physical, functional, and environmental needs and capacities to engage in daily life and physical activity. A health insurance carrier shall cover medically necessary services and supplies for CRT devices that meet each insured’s mobility needs.

“CRT device” includes manual and power wheelchairs and mobility devices, including seating and positioning equipment and accessories, designed, manufactured, configured, adjusted, or modified for a specific insured to meet that insured’s unique medical, physical, functional, and environmental needs. Among these important physical needs is participation in athletic events, which promotes positive social and health outcomes for all New Mexicans. CRTs are generally not useful to an insured without a disability, illness, injury, or other medical condition.

For complete content please see PDF below.

COVERAGE REQUIREMENTS AND STANDARDIZED LANGUAGE REGARDING COMPLEX REHABILITATION TECHNOLOGY (CRT)