New Mexico expands health insurance coverage for diabetic foot ulcer treatments

Yahoo

14-04-2025

The American Diabetes Association said New Mexico is the first U.S. state to require state-regulated health insurance plans to cover medically necessary treatments for diabetic foot ulcers. (Photo by Getty Images)
More New Mexicans will be able to receive treatment for diabetic foot ulcers, thanks to a first-in-the-nation requirement for some health insurance plans to cover the costs.
Gov. Michelle Lujan Grisham on April 7 signed into law House Bill 233, which requires state-regulated health insurance plans to pay for medically necessary treatments for diabetic foot ulcers starting in 2026.
In a news release on April 8, the American Diabetes Association applauded the new law and said it makes New Mexico the first U.S. state to require state-regulated health insurance plans to cover these treatments.
Diabetes-related foot ulcers affect approximately 15 to 25% of all people with diabetes at some point in their lifetime, the ADA said in the news release, and 15% of people with a diabetes-related foot ulcer will require an amputation.
In New Mexico, approximately 217,400 adults, or 13.1% of adults in the state, have diagnosed diabetes, with an estimated 9,800 adults receiving the diagnosis each year, according to the state Department of Health's analysis of HB233.
Diabetic foot ulcers can lead to loss of the ability to walk, infection, hospitalization, lower-extremity amputation and death, according to a review article in the ADA's journal Diabetes Care.
Christine Fallabel, the ADA's director of state government affairs, told Source NM that people with these ulcers have found that insurance does not cover the specialized podiatric treatments to fight the infection and save the foot.
Other states have not tried to introduce similar legislation, Fallabel said, because there is a lot of stigma around diabetes and foot health, and policymakers generally don't know about the problem.
Fallabel, who has lived with Type 1 Diabetes for the last 25 years, said one of those treatments, called topical oxygen therapy, has resulted in a 71% reduction in amputations, an 88% reduction in hospital visits and a six times higher likelihood of healing within three months, she said.
'There's really good data coming out about targeting diabetic foot ulcers with this high-pressure oxygen therapy that, until this bill was signed, most insurers wouldn't cover for one reason or another,' Fallabel said.
Other services that podiatrists could try and would be covered by health insurance under the new law could also include antibiotics or physical therapy, Fallabel said.
State-regulated health insurance plans include a range of private health insurance plans managed by the state government, Fallabel said. It does not include Medicare or Medicaid patients, she said.
Some state Medicaid programs cover these kinds of treatments but New Mexico's does not, Fallabel said. During the recent legislative session, some lawmakers expressed interest in returning in a future session to change the Medicaid program to cover these treatments too, she said.
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