Rodarte v. Presbyterian Insurance Co.

OPINION

HANISEE, Judge.

{1} This case requires us to determine whether certain medical treatment is covered by a plan participant’s health benefits plan or required by applicable regulations governing such contracts. After Albert Rodarte’s (Rodarte) daughter, Jessica, suffered a severely disabling anoxic brain injury, he sought pre-approval ¡from her health insurance company for Jessica to receive hyperbaric oxygen therapy (HBOT). Presbyterian Insurance Company (Presbyterian) denied the request, concluding that the treatment was not a covered benefit. On review, the New Mexico Superintendent of…