What are you looking for? Fraud AssessmentsCompany LicensingApplying for Admission & ApplicationsRenewalsStatutory DepositsFeesLife and Health DivisionProduct FilingPharmacy Benefit Managers (PBM) Reports, New Mexico Health Access Survey, and BriefsContracted and External ReportsOSI Health Insurance BriefsThe 2023 New Mexico Health Access SurveyResource BinderConsumer Assistance Plan Continuous Quality ImprovementCoverage for Individuals with Diabetes (HB53)Cultural and Linguistic PlanDebt Collection Protection Act - Provider ResourceDental Provider CredentialingGuidance for CarriersHealth Rate ReviewManaged Health Care Compliance DeadlinesMember GrievanceMental Health ParityMonthly Member EnrollmentNetwork AdequacyPrescription Drug Price TransparencyProvider CredentialingProvider GrievanceRequest for Confidential StatusSmall Business Health Insurance Premium Relief InitiativeUtilization ManagementVaccine Purchasing ActProperty & CasualtyFinancial RegulationAccredited ReinsurersFinancial StatementsFinancial Statements ArchiveFinancial Examinations Financial Examinations ArchiveFinancial and Market Conduct Examinations - ArchiveTitle Insurance Forms & TablesASR USR Schedules & InstructionsStatistical ReportsIndividuals and AgenciesContinuing Education (CE)Criminal OffenseLicense Status VerificationAnnual/Quarterly Checklists OSI Events Calendar View our calendar of events OSI regulates insurers’ provider access for major medical health insurance plans. See details below on OSI’s provider access regulatory requirements. Please download and review each document carefully. If a web preview distorts the formatting, downloading the file directly should correct the issue. Network Adequacy – Existing Networks Network Adequacy Guidance Chart_v1 (Updated 10/2025) Cover Letter_v1 (Updated 10/2025) Attestation_v1 (Updated 10/2025) Templates – Existing Networks Section 1 Template Provider Directory Accuracy_v1 (Updated 10/2025) Section 1 Template Provider Directory Screenshots_v1 (Updated 10/2025) Section 2 Template Provider Directory Searches_v1 (Updated 10/2025) Workbooks – Existing Networks Section 1 Workbook Provider Directory Accuracy_v1 (Updated 10/2025) Section 3 Workbook Time and Distance_v1 (Updated 10/2025) Section 4 Workbook Provider Lists_v1 (Updated 10/2025) Section 5 Workbook Wait Times_v1 (Updated 10/2025) Section 6 Workbook Exceptions Requests_v1 (Updated 10/2025) Network Adequacy – New Networks Filing Instructions – 2023 Filing Instructions – 2022 Provider Data Reporting Templates for QHPs only Required Network Adequacy Reporting Template Instructions Provider Template Facility Template Provider Specialty Crosswalk Glossary of Terms Reports and News Surprise Billing Press Release Regulations 13.10.22.8 NMAC 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. Know Your Rights Endorsement Benchmark Organization Selection RFI Response Bulletin 2019-012 Data Calls Bulletin 2025-003 Surprise Billing Data Call template – Updated 05/2025 Reports (Coming Soon) Air Ambulance No Surprises Act (Coming Soon) Rules – 13.10. 28 NMAC Complaints Members can file complaints about network adequacy here Providers can file complaints about network adequacy here
August 24, 2026 Bulletins COVERAGE REQUIREMENTS AND STANDARDIZED LANGUAGE REGARDING COMPLEX REHABILITATION TECHNOLOGY (CRT) BULLETIN 2026-012: During the 2023 Legislative Session, Governor Michelle Lujan Grisham signed House Bill 131 specifying medical necessity and nondiscrimination standards that provide coverage for prosthetic and orthotic devices. During the 2026 Legislative Session, the governor expanded access by signing House Bill 38 to amend Sections 59A‑16‑21.4, 59A‑22‑62, 59A‑23‑32, 59A‑46‑72, and 59A‑47‑66 NMSA 1978. Legislative testimony in […] Read More
June 26, 2026 Bulletins COMPENSATION OF HEARING OFFICERS AND CO-HEARING OFFICERS DESIGNATED ON HEARINGS UNDER 13.10.16 AND 13.10.17 NMAC BULLETIN 2026-007: This Bulletin repeals and replaces Bulletins Nos. 2003-006 and 2015-008, and any other Bulletin on this same topic issued prior to the date of this Bulletin. This Bulletin is issued in accordance with NMSA 1978, Sections 59A-2-8 and 59A-57-1 through – 11; and 13.10.16 and 13.10.17 NMAC. The purpose of this Bulletin is to amend […] Read More
