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The New Mexico Department of Health reported 135,388 patients were enrolled in the medical cannabis program as of May, of whom 55 percent are seeking treatment for post-traumatic stress disorder as their primary qualifying condition.
A new class-action lawsuit argues those patients are eligible to have their cannabis covered by their health insurance, including Medicaid.
In May alone, medical cannabis sales in New Mexico topped $17.4 million, holding steady from $17.3 million in April, the first month that non-medical cannabis sales opened to adults.
A group of medical cannabis patients, including a state legislator, joined the state’s largest medical cannabis producer and retailer in filing a complaint in New Mexico’s 2nd Judicial District, seeking damages and a declaration by the court that medical cannabis is a behavioral health service that must be fully covered by insurers without copays, deductibles or coinsurance.
Among the plaintiffs is state Sen. Jacob Candelaria, an independent state legislator from Albuquerque, who is a medical cannabis patient and an attorney who has been involved in cannabis litigation previously. Candelaria announced last year that he won’t seek reelection to the body.
Most of the plaintiffs list PTSD as their primary qualifying condition under the state’s medical cannabis program, with some stating they have other conditions as well. One plaintiff is the father of a pediatric patient approved to take cannabis for treatment of nonverbal autism and epilepsy.
PTSD has been a medically approved condition qualifying patients for New Mexico’s medical cannabis program since 2009. As of May, 74,006 patients listed it as their primary condition.
Ultra Health, a producer of medical and non-medical cannabis products with dispensaries throughout New Mexico, is the single producer among the plaintiffs. The company’s CEO and president, Duke Rodriguez, stated in a news release: “The idea of health insurance plans paying for medical cannabis may seem like an impossible dream, but all the foundational elements have already fallen into place.”
The complaint rests its claim on a New Mexico statute enacted in 2021 that barred insurance companies from imposing cost-sharing for behavior health services covered by individual or group health plans. The bill, styled as the No Behavioral Health Cost Sharing Act, was sponsored by Democratic state Sens. Martin Hickey of Albuquerque and Jeff Steinborn of Las Cruces.
The complaint also points to state appeals court rulings holding medical cannabis exempt from taxation like other prescription medications.
The plaintiffs claim that by refusing to cover medical cannabis for their members, insurance companies were violating state law, breaching contracts with enrollees and unjustly enriching themselves, among other claims. Besides a declaratory judgment they are seeking punitive damages, recovery of money patients paid for medical cannabis since Jan. 1, and court costs and attorneys’ fees.
Insurers named as defendants in the suit include Blue Cross/Blue Shield of New Mexico, True Health New Mexico, Cigna Health and Life Insurance Co., Molina Healthcare of New Mexico, Presbyterian Insurance Co. and Presbyterian Health Plan as well as Western Sky Community Care, Inc.
Algernon D’Ammassa can be reached at 575-541-5451, adammassa@lcsun-news.com or @AlgernonWrites on Twitter.
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