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New Mexico Cannabis Firm Files Lawsuit Asking Health Insurers to Cover Medical Cannabis for Behavioral Health Conditions

Ultra Health, New Mexico’s largest medical cannabis producer, filed a lawsuit with the state to force insurers to pay mental and behavioral health patients’ costs for cannabis medication.

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New Mexico’s largest licensed cannabis producer has filed a lawsuit seeking to force health insurers to cover the cost of medical cannabis for patients enrolled in the state program for behavioral health conditions, the Santa Fe New Mexican reports. The lawsuit claims that a law passed last year, which prohibits insurers from requiring patients to share the cost of medications for mental or behavioral health, should apply to patients using cannabis for their conditions.

The class-action lawsuit on behalf of six named patients by Ultra Health also seeks damages since the patients have been forced to pay the total cost for their own medical cannabis used to treat their mental health and behavioral conditions.

The complaint, which was filed last week in state District Court in Bernalillo County, also seeks “disgorgement of the millions of dollars in excess profits and revenues retained” by the insurance companies via an award of an unspecified amount of punitive damages to be determined by a jury.

One of the named plaintiffs is state Sen. Jacob Candelaria (D) who uses cannabis to treat symptoms of post-traumatic stress disorder.

Ultra Health President Duke Rodriguez estimated that about 55% of the state’s medical cannabis patients – about 74,000 people – are enrolled in the program, at least partly, for PTSD-related symptoms.

“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. Revolutionizing behavioral healthcare in New Mexico will take only a few small steps, rather than a giant leap.” — Rodriguez in a statement, via the New Mexican

The insurance companies named as defendants include Blue Cross and Blue Shield of New Mexico; Cigna Health and Life Insurance Company; True Health New Mexico; Molina Healthcare of New Mexico; Presbyterian Health Plan; Presbyterian Insurance Company; and Western Sky Community Care, the report says.  

Ultra Health and Rodriguez have previously sued the state over plant counts, purchase limits, and the number of dispensaries allowed by licensees. In February, in a lawsuit brought by Ultra Health, the state Supreme Court ruled that medical cannabis purchases in the state are not subject to its gross receipts tax.  

Medical cannabis producers in the state had requested tax refunds in 2014 and in 2018 but the state Taxation and Revenue Department had denied those claims. In 2020, New Mexico Court of Appeals Judge M. Monica Zamora ruled that medical cannabis should be treated like other prescriptions, which are not taxed. Ultra Health had not been charging patients taxes, opting instead to absorb such taxes. The company said that it would receive a $7.4 million refund plus interest following the Supreme Court ruling.

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