2019 New Mexico Statutes
Chapter 52 - Workers' Compensation
Article 4 - Health Care Providers
Section 52-4-1 - Definition; health care provider.
As used in Chapter 52 NMSA 1978, "health care provider" means:
A. a hospital maintained by the state or a political subdivision of the state or any place currently licensed as a hospital by the department of health that has:
(1) accommodations for resident bed patients;
(2) a licensed professional registered nurse always on duty or call;
(3) a laboratory; and
(4) an operating room where surgical operations are performed;
B. an optometrist licensed pursuant to the provisions of Chapter 61, Article 2 NMSA 1978;
C. a chiropractic physician licensed pursuant to the provisions of Chapter 61, Article 4 NMSA 1978;
D. a dentist licensed pursuant to the provisions of Chapter 61, Article 5 NMSA 1978;
E. a physician licensed pursuant to the provisions of Chapter 61, Article 6 NMSA 1978;
F. a podiatrist licensed pursuant to the provisions of Chapter 61, Article 8 NMSA 1978;
G. an osteopathic physician licensed pursuant to the provisions of Chapter 61, Article 10 NMSA 1978;
H. a physician assistant licensed pursuant to the provisions of Section 61-6-7 NMSA 1978;
I. a certified nurse practitioner licensed pursuant to Section 61-3-23.2 NMSA 1978;
J. a physical therapist licensed pursuant to the provisions of Chapter 61, Article 12 NMSA 1978;
K. an occupational therapist licensed pursuant to the provisions of Chapter 61, Article 12A NMSA 1978;
L. a doctor of oriental medicine licensed pursuant to the provisions of Chapter 61, Article 14A NMSA 1978;
M. an athletic trainer licensed pursuant to the provisions of Chapter 61, Article 14D NMSA 1978;
N. a psychologist who is duly licensed or certified in the state where the service is rendered, holding a doctorate degree in psychology and having at least two years of clinical experience in a recognized health setting, or who has met the standards of the national register of health services providers in psychology;
O. a certified nurse-midwife licensed by the board of nursing as a registered nurse and registered with the behavioral health services division of the human services department as a certified nurse-midwife;
P. a pharmacist licensed pursuant to the provisions of Chapter 61, Article 11 NMSA 1978; or
Q. any person or facility that provides health-related services in the health care industry, as approved by the director.
History: 1978 Comp., § 52-4-1, enacted by Laws 1983, ch. 116, § 1; 1989, ch. 263, § 69; 1990 (2nd S.S.), ch. 2, § 49; 1993, ch. 158, § 2; 2007, ch. 325, § 11; 2007, ch. 327, § 1; 2007, ch. 328, § 3.
ANNOTATIONS2007 Multiple Amendments. — Laws 2007, ch. 325, § 11, Laws 2007, ch. 327, § 1 and Laws 2007, ch. 328, § 3 enacted different amendments to this section that can be reconciled. Pursuant to 12-1-8 NMSA 1978, Laws 2007, ch. 328, § 3, as the last act signed by the governor, is set out above and incorporates all amendments. The amendments enacted by Laws 2007, ch. 325, § 11, Laws 2007, ch. 327, § 1 and Laws 2007, ch. 328, § 3 are described below. To view the session laws in their entirety, see the 2007 session laws on NMOneSource.com.
Laws 2007, ch. 328, § 3, effective June 15, 2007, added Subsection O.
Laws 2007, ch. 325, § 11, effective June 15, 2007, changed "chiropractor" to "chiropractic physician" and "department of health" to "human services department".
Laws 2007, ch. 327, § 1, effective June 15, 2007, added athletic trainers to the definition of "health care provider".
The 1993 amendment, effective June 18, 1993, in Subsection A, substituted "a hospital" for "any hospital", "a political" for "any political", and "department of health" for "health and environment department"; substituted "Section 61-3-23.2" for "Section 61-3-14" in Subsection I; substituted "a doctor of oriental medicine" for "an acupuncture practitioner" in Subsection L; and substituted "department of health" for "health and environment department" in Subsection N.
The 1990 (2nd S.S.) amendment, effective January 1, 1991, rewrote this section, which formerly prohibited restrictions in workers' compensation policies on choice of health care providers, to the extent that a detailed comparison would be impracticable.
"Health care provider" is a phrase with a very specific meaning and includes those in professions whose expertise would not necessarily require "scientific knowledge." Banks v. IMC Kalium Carlsbad Potash Co., 2003-NMSC-026, 134 N.M. 421, 77 P.3d 1014.
Health care provider, no NewMexico license. — The phrase "health care provider" used throughout the 1987 Workers' Compensation Act is a shorthand expression referring to licensed occupations without reference to the requirement of licensure in New Mexico. Coslett v. Third St. Grocery, 1994-NMCA-046, 117 N.M. 727, 876 P.2d 656, cert. denied, 117 N.M. 802, 877 P.2d 1105.
Worker is eligible to receive and have insurance carrier pay for services of chiropractor if the care was related to a compensable disability and such services are deemed reasonable and necessary. Salcido v. Transamerica Ins. Group, Inc., 1985-NMSC-002, 102 N.M. 217, 693 P.2d 583.
Employer's failure to provide services. — In the event of the employer's failure to provide services in accordance with the statutory standard, the worker may seek the services of another health provider and require the employer to pay for such services, provided such treatment is related to the injury and is reasonable and necessary. The question of whether the employer has provided services in accordance with that standard is ordinarily a question of fact and depends on the circumstances of the particular case. Bowles v. Los Lunas Schs., 1989-NMCA-081, 109 N.M. 100, 781 P.2d 1178, cert. denied, 109 N.M. 131, 782 P.2d 384.
Standard for admitting expert testimony established by Daubert v. Merrel Dow Pharmaceuticals, Inc., 509 U.S. 579 (1993), as adopted in New Mexico by State v. Alberico, 1993-NMSC-047, 116 N.M. 156, 861 P.2d 192, does not apply to the testimony of a health care provider pursuant to Section 52-1-28(B) or 52-3-32 NMSA 1978. Banks v. IMC Kalium Carlsbad Potash Co., 2003-NMSC-026, 134 N.M. 421, 77 P.3d 1014.
Law reviews. — For case note, "Workers' Compensation Law: A Clinical Psychologist Is Qualified to Give Expert Medical Testimony Regarding Causation: Madrid v. Univ. of California, d/b/a Los Alamos National Laboratory," see 18 N.M.L. Rev. 637 (1988).
For survey of 1990-91 workers' compensation law, see 22 N.M.L. Rev. 845 (1992).
Am. Jur. 2d, A.L.R. and C.J.S. references. — 82 Am. Jur. 2d Workers' Compensation §§ 435 to 445.
Workers' compensation: reasonableness of employee's refusal of medical services tendered by employer, 72 A.L.R.4th 905.
99 C.J.S. Workmen's Compensation §§ 266 to 277.
