Lawsuit in New Mexico Seeks Medical Marijuana Insurance Coverage

Ultra Health, the largest marijuana company in New Mexico, along with a group of patients, have filed a class-action lawsuit against seven insurance providers in New Mexico over the issue of providing medical marijuana insurance coverage.

The lawsuit is the latest example of how the lack of insurance coverage for medical marijuana is causing ongoing issues for patients who rely on it. They may qualify for their state legal medical marijuana program and have it prescribed for them by a doctor, but they still cannot get insurance coverage to help them with the cost for its use.

Ultra Health and the patients demanded that insurers cover the cost of cannabis for qualified patients. There are six patients taking part in the lawsuit, including one father participating on behalf of a minor patient.

Defendants in the lawsuit include seven health insurance companies, including some of the biggest providers in the state like Blue Cross and Blue Shield of New Mexico, Cigna Health and Life Insurance Company, and True Health New Mexico.

Lawsuit Cites the Behavioral Health Services Equity Act

The lawsuit states that under New Mexico law, the cost of a medication or medical service that treats behavioral disorders or mental health conditions should be covered without cost-sharing.

This refers to the Behavioral Health Services Equity Act, a state law enacted in 2021. According to the lawsuit, if a health insurance provider has coverage for a behavior or mental health service, they should cover the entire cost of that service.

Ultra Health and the patients involved in the lawsuit believe the court should recognize that medical cannabis is a recognized treatment option for behavioral and mental health issues in New Mexico and therefore should get the medical coverage it deserves.

Along with the health coverage, the lawsuit asks for compensation for related medical expenses made since the behavioral health law took effect in January.

Previous Efforts to Get Medical Marijuana Insurance Coverage Were Ignored

Months before filing the lawsuit, Ultra Health sent out a letter to the insurance companies asking them to confirm they would eliminate cost-sharing and out-of-pocket costs for medical marijuana used for behavioral or mental health treatment, per the new legislation. The letter states that coverage is “actually a rational, reasonable notion when considered in light of other New Mexico law.”

The letter, sent in February, offered assistance in creating an efficient system to process insurers medical claims. However, the insurers never responded to the letter, so Ultra Health went forward with the lawsuit, according to Marijuana Moment.

Ignoring coverage for medical marijuana with this new law in place is “intentionally and in a reckless and willful disregard of the rights of Plaintiffs for which they are entitled to punitive damages,” according to the lawsuit.

This isn’t the first time medical marijuana insurance has been the topic of a New Mexico lawsuit. In 2020, a state judge decided that incarcerated patients who use medical marijuana cannot face punishment for using cannabis.

As of the end of May, New Mexico has 135,388 patients in the state’s medical cannabis program, according to New Mexico’s Department of Health.

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