N.M. Admin. Code § 13.21.1.7

Current through Register Vol. 35, No. 24, December 23, 2024

Section 13.21.1.7 - DEFINITIONS

This chapter adopts the definitions found in Section 41-5-3 NMSA 1978, in Section 14-4-2 NMSA 1978, in Chapter 59A, Article 1, NMSA 1978, and in 1.24.1.7 NMAC. In addition:

A."Base coverage" means the medical malpractice liability coverage, as required by the MMA or as determined by the superintendent for a hospital or outpatient health care facility, that must be provided by an insurance policy issued to a health care provider;

B."Insured" means a health care provider insured under a medical malpractice liability insurance policy;

C."MMA" means the New Mexico Medical Malpractice Act, Sections 41-5-1 through 41-5-29 NMSA 1978;

D."Occurrence coverage" means malpractice liability insurance for medical malpractice that occurs during the policy term, regardless of when the claim was reported;

E."Qualified health care provider" or "QHP" means a health care provider, as defined in Subsection A of Section 41-5-1 NMSA 1978, who is admitted to the fund pursuant to these rules;

F."Self-insured" means a person who satisfies, or seeks to satisfy, the requirements for becoming a "qualified health care provider" by depositing funds with the superintendent;

G."Slot coverage" means prohibited coverage for more than one part-time health care provider on a "full-time equivalency" (FTE) basis calculated on how many hours, collectively, the part-time health care providers would be working during the period of coverage and calculating the premium as comparable to the one full-time health care provider's premium; and

H."Third-party administrator" or "TPA" means the third-party administrator identified in Section 41-5-25 NMSA 1978.

N.M. Admin. Code § 13.21.1.7

Adopted by New Mexico Register, Volume XXX, Issue 08, April 23, 2019, eff. 4/30/2019, Adopted by New Mexico Register, Volume XXXII, Issue 23, December 14, 2021, eff. 1/1/2022