New Mexico Lawsuit Seeks Insurance Coverage for Medical Cannabis

A New Mexico cannabis enterprise and a group of 6 health-related cannabis clients have submitted a class-motion lawsuit that seeks insurance policy protection for medicinal hashish. The authorized motion was submitted on Friday in Albuquerque state district courtroom, with the plaintiffs arguing that health care hashish should be included because it is a legitimate behavioral wellbeing support.

The plaintiffs in the fit are New Mexico Top Organics-Extremely Wellbeing and 6 clinical hashish people including condition Sen. Jacob Candelaria. Documents submitted in the circumstance note that Candelaria has been a clinical hashish affected individual due to the fact 2019, when his physician suggested that he use medicinal hashish to address submit-traumatic anxiety problem soon after antidepressants unsuccessful to deliver relief. Candelaria pays among $500 and $1,000 per month out of pocket for his treatment simply because his insurance provider, Blue Cross and Blue Shield of New Mexico, fails to go over medical cannabis for its consumers, according to the lawsuit.

With the lawful action, the plaintiffs in the circumstance are seeking “recovery for on their own, and for each individual other similarly situated behavioral or mental health and fitness affected individual unlawfully subjected to shelling out for the complete charge of medically necessary cannabis, in violation of point out regulation.”

The lawsuit names Blue Cross and Blue Protect of New Mexico, Legitimate Wellness New Mexico, Cigna Well being and Life Coverage Co., Molina Healthcare of New Mexico, Presbyterian Health Strategy, Presbyterian Insurance policy Co. and Western Sky Community Treatment as defendants in the lawful motion. The lawsuit is based on laws passed past year, Senate Bill 317, which requires insurers to protect 100% of the charges for behavioral health and fitness services, including treatment options prescribed for behavioral health and fitness disorders. The evaluate was passed in April 2021 and went into result on January 1 of this calendar year.

“The notion of health coverage strategies spending for medical cannabis may perhaps appear to be like an unattainable dream, but all the foundational aspects have previously fallen into position,” Extremely Well being president and CEO Duke Rodriguez reported in a statement to the Albuquerque Journal on Monday. “Revolutionizing behavioral health treatment in New Mexico will choose only a several modest actions, somewhat than a huge leap.”

February Letter Sought Coverage for Medical Hashish in New Mexico

In February, Extremely Well being despatched a letter to insurers and the Workplace of the Superintendent of Insurance policy in search of coverage for healthcare hashish advised to treat behavioral well being circumstances. The letter bundled info supplied by the New Mexico Section of Well being in April that suggests of the 134,307 sufferers enrolled in the condition health-related hashish program, 73,000 have been diagnosed with PTSD.

“Ultra Wellbeing acknowledges that the concept of wellbeing insurers shelling out for healthcare cannabis may perhaps feel novel at to start with blush,” the company wrote in its letter to Presbyterian Healthcare Expert services. 

“However,” the letter proceeds, “it is really a rational, reasonable notion when deemed in light-weight of other New Mexico law. New Mexico presently necessitates staff payment insurers to pay out for health care hashish, and New Mexico already treats medical hashish the very same as common prescription medications. The simple fact that health and fitness insurers should—and will—pay for professional medical cannabis is not groundbreaking at this issue. It is the following logical step, and it is a tiny action, not a huge leap.”

Real Well being New Mexico and Blue Cross and Blue Shield of New Mexico declined to comment on the scenario, in accordance to media stories. Molina Health care of New Mexico, Western Sky Neighborhood Treatment and Cigna did not right away react to requests for commentary. Presbyterian Health and fitness Plan and Presbyterian Insurance plan Co., which are overseen by the exact management group, also declined to remark on the scenario but issued a assertion on the companies’ policies.

“Presbyterian Well being System is committed to making certain that New Mexicans can entry the behavioral health and fitness providers they will need,” spokeswoman Melanie Mozes said. “We have not yet been served with the lawsuit and will reserve remark for the appropriate venue.”

Rodriquez said that the lawsuit was submitted after the insurers and state regulators failed to respond to the letter despatched in February. He also famous that other patients who have been impacted by the insurers’ failure to cover health care hashish recommended as a behavioral overall health remedy are welcome to be part of the authorized motion.

“There will be far more individuals identified who have been harmed by insurers not lawfully abiding to the statutory duty of eradicating any charge sharing associated to behavioral health companies,” Rodriguez stated. “Insurers have not acted in good religion.”

In an job interview, Candelaria explained that medical hashish has aided him cope with PTSD and positively impacted his existence. He additional that he joined the lawful action to support all “New Mexicans who are having difficulties to pay for their wellbeing treatment.”

“Senate Bill 317 was transformational,” Candelaria claimed. “This accommodate, you know, it turns into required to basically make that transformation take place.”