N.M. Admin. Code § 16.4.17.9

Current through Register Vol. 36, No. 1, January 14, 2025

Section 16.4.17.9 - CHIROPRACTIC INSURANCE CONSULTANTS AND PEER REVIEW CONTRACTORS

A. Chiropractic insurance consultants and peer review contractors advise insurance companies, third-party administrators and other similar entities of New Mexico standards of:

(1) recognized and accepted chiropractic services and procedures permitted by the New Mexico chiropractic statute, usual and customary practices and procedures and administrative rules; and

(2) the propriety of chiropractic diagnosis and care.

B. All licensees who review chiropractic records for the purposes of determining the adequacy or sufficiency of chiropractic treatments, or the clinical indication for those treatments, shall notify the board annually that they are engaged in those activities and of the location where those activities are performed.

C. Any person or professional shall not hold themselves out as chiropractic insurance consultants or provide chiropractic peer review services unless they meet the following requirements:

(1) hold a current chiropractic license in New Mexico;

(2) have practiced chiropractic in the state of New Mexico during the immediately preceding five years;

(3) are actively involved in a chiropractic practice during the term of employment as a chiropractic insurance consultant or peer review consultant; active practice includes but is not limited to maintaining an office location and providing clinical care to patients that comprises more than fifty percent of their total compensable work product.

N.M. Admin. Code § 16.4.17.9

16.4.17.9 NMAC - N, 3/31/09, Adopted by New Mexico Register, Volume XXX, Issue 14, July 30, 2019, eff. 8/10/2019