June 23, 2025 Bulletins DATA CALL PURSUANT TO THE SURPRISE BILLING PROTECTION ACT (ACT), NMSA 1978, CHAPTER 59A, ARTICLE 57A OF THE INSURANCE CODE BULLETIN 2025-003 Pursuant to NMSA 1978, Section 59A-57A-l1 of the Act, the Superintendent of Insurance (Superintendent) “may require health insurance carriers” to “report the annual percentage of claims and expenditures paid to nonparticipating providers for health care services,” to monitor the effectiveness of the requirements in the Act, and the impact on provider networks and health care costs. This monitoring requires establishment of a data baseline pre-enactment of the Surprise Billing Protection Act in 2020. 13.10.33.11 NMAC requires carriers to submit a surprise billing data report using a template provided by the Superintendent. The rule requires carriers to file this report annually by May 1 of each year. The report is required to contain data from the full prior calendar year. OSI has updated the Surprise Billing Data Call Template to clarify instructions and to capture additional information required by the OSI to assess the effectiveness of the requirements of the Surprise Billing Act. The overall layout of the report remains the same, with new data fields added. Below is a list of the changes made to help understand the differences between the two versions. The new Surprise Billing Data Call Template can be found on OSI’s website at the following link:Office of Superintendent of Insurance (state.nm.us) For complete bulletin content please see PDF below. DATA CALL PURSUANT TO THE SURPRISE BILLING PROTECTION ACT (ACT), NMSA 1978, CHAPTER 59A, ARTICLE 57A OF THE INSURANCE CODE (PDF)
