December 20, 2023 Announcements NOTICE OF ROUNDTABLE MEETING 13.4.2, 3, 4, 7 & 8 NMAC The New Mexico Office of Superintendent of Insurance has scheduled a virtual roundtable meeting to discuss an upcoming rulemaking and is interested in obtaining outside perspectives. The purpose of this roundtable meeting is to informally discuss the potential adoption of what would be Title 13, Chapter 4, Parts 2, 3, 4, 7, & 8 of […] Read More
December 13, 2023 Bulletins APPLICATION OF OPEN ENROLLMENT AND SPECIAL ENROLLMENT PERIODS TO INDIVIDUAL OFF-EXCHANGE PLANS Bulletin 2023-037: The New Mexico Office of Superintendent of Insurance (OSI) is issuing this bulletin to clarify the application of annual open enrollment periods (OEPs) and special enrollment periods (SEPs) to the sale of individual, fully-insured, major medical plans that meet qualified health plan standards and are sold outside the New Mexico Health Insurance Exchange (off-exchange plans). […] Read More
December 1, 2023 Bulletins SMALL BUSINESS HEALTH INSURANCE PREMIUM RELIEF INITIATIVE PREMIUM REDUCTION PERCENTAGE FOR COVERAGE BULLETIN 2023-036: THIS BULLETIN is issued pursuant to NMSA 1978, Section 59A-23F-11, which established the Health Care Affordability Fund to “reduce premiums for small businesses and their employees.” This Bulletin sets forth program parameters, requirements for issuers, and the Office of Superintendent of Insurance’s (OSI’s) responsibilities under the Small Business Health Insurance Premium Relief Initiative established in […] Read More
November 21, 2023 Bulletins PHARMACY BENEFIT MANAGER APPLICATION FOR A LICENSE AND LICENSE RENEWAL REQUIREMENTS BULLETIN 2023-035: Effective December 1, 2023, this Bulletin applies to any Pharmacy Benefit Manager (PBM) operating in the State of New Mexico that is required to be licensed in New Mexico pursuant to the Pharmacy Benefit Manager Act Section 59A-61-1 et seq. N.M.S.A. 1978. The process for applying for or renewing a license has changed. New and […] Read More
September 20, 2023 News Releases Superintendent of Insurance Increases Access to Behavioral Health Services New Mexico’s Superintendent of Insurance, Alice T. Kane, issued an emergency order requiring commercial health insurers to expand timely access to behavioral health services. Superintendent of Insurance Increases Access to Behavioral Health Services Read More
August 29, 2023 Announcements NOTICE REGARDING NM FRAUD ASSESSMENT OSI is issuing this Notice to extend the deadline to pay the New Mexico Fraud Assessment until October 2, 2023, listed on the NAIC Checklist and the OSI website. After October 2, 2023, the determined rate of the fraud assessment and fee shall subject the insurer to a penalty of one thousand dollars ($1,000.00) per […] Read More
August 9, 2023 Bulletins REQUIREMENTS FOR RESIDENTIAL PROPERTY COVERAGE ON MANUFACTURED HOMES BULLETIN 2023-022: THIS BULLETIN reminds insurers that manufactured homes, while it is in a residential property situation, must be covered as such. This bulletin is issued in accordance with Section 59-2-8 NMSA 1978, 13.1.2 NMAC, 13.7.4, and 13.13.2 NMAC. REQUIREMENTS FOR RESIDENTIAL PROPERTY COVERAGE ON MANUFACTURED HOMES Read More
August 4, 2023 Bulletins PBM Data Call Bulletin August 2023 BULLETIN 2023-024: OSI is issuing this Bulletin to clarify the interpretation of NMSA 1978 § 59A-61-7, and to remind all PBMs that it remains illegal to charge pharmacies any claims adjudication fees, regardless of whether these fees are itemized in a contract. The Legislature enacted this section of the Pharmacy Benefits Manager Regulation Act to ban these […] Read More
July 25, 2023 Bulletins STANDARDIZED LANGUAGE REGARDING MEDICAL NECESSITY AND NONDISCRIMINATION STANDARDS FOR COVERAGE OF PROSTHETICS OR ORTHOTICS DE BULLETIN 2023-023: During the 2023 Legislative Session, Governor Michell Lujan Grisham signed House Bill 131 specifying medical necessity and nondiscrimination standards for the coverage of prosthetics or orthotics devices. The Office of Superintendent of Insurance (OSI) works to ensure that insurers supply accurate and understandable information that clearly explains health insurance rights and benefits to consumers. During […] Read More
July 19, 2023 Bulletins NETWORK ADEQUACY AND REIMBURSEMENT NQTL DATA CALL BULLETIN 2023-021: The Consolidated Appropriations Act, 2021, which was signed into law and became effective December 27, 2020, included an amendment to Section 2726(a) of the Public Health Service Act, Strengthening Parity in Mental Health and Substance Use Disorder benefits. The Final Rules for the Mental Health Parity and Addiction Equity Act of 2008, (MHPAEA), were issued […] Read More
