• Network Adequacy

OSI regulates insurers’ provider access for major medical health insurance plans. See details below on OSI’s provider access regulatory requirements.

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Network Adequacy – Existing Networks

Templates – Existing Networks

Workbooks – Existing Networks

Network Adequacy – New Networks

Provider Data Reporting Templates for QHPs only

Reports and News

Regulations

Dental Network Adequacy

  • 13.10.35 NMAC
  • Letter of self-attestation of compliance due Oct. 1st of each year

Surprise Billing

Surprise billing happens when people unknowingly get care from providers that are outside of their health plan’s network and can happen for both emergency and non-emergency care. OSI is responsible for the enforcement of New Mexico’s Surprise Billing Protection Act and portions of the federal No Surprises Act.

Complaints

  • Members can file complaints about network adequacy here
  • Providers can file complaints about network adequacy here

Recent News

Get the latest information about rule changes, legislation, industry information and consumer news.

Read All OSI News

ORDER ESTABLISHING PARAMETERS FOR DEFRAYAL UNDER 13.10.41 NMAC, COVERAGE FOR SPECIFICED SEX TRAIT MODIFICATION PROCEDURE

Pursuant to NMSA, Section 59A-2-8 General powers and duties of superintendent, this order provides an initial interpretation of what specified sex trait modification procedures and prescriptions are eligible for defrayal starting Plan Year 2027 for health plans sold on the New Mexico BeWell Exchange. Office of Superintendent of Insurance (OSI) staff may revisit this interpretation […]

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MEDICAL MALPRACTICE PREMIUM REDUCTION

BULLETIN 2026-010: The New Mexico State Legislature appropriated $5 million to the New Mexico Office of Superintendent of Insurance (OSI) to address medical malpractice insurance costs for individual providers. The appropriation was part of a supplemental appropriation package passed in 2025. This one-time appropriation directs OSI to provide a premium subsidy for private medical malpractice insurance policies. […]

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