OSI Events Calendar View our calendar of events Managed Health Care Complaint Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. – Step 1 of 5The Managed Health Care Bureau will investigate this complaint to determine if there are any violations of the New Mexico Insurance Code, Managed Health Care Rule or insurance policy language. that Are an Name *FirstLastMailing AddressAddress Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone (Home ) *Phone (Work )Phone (Mobile )Email *NextName of Insurance CompanyBCBS of New MexicoMolinaPresbyterianUnited HealthcareOther (please list other insurance company below)Insurance company nameType of Healthcare CoverageIndividualGroupOtherPlease list the others hereMember/Individual ID#Group ID#Employer NameOther(Explain)Type of Healthcare Plan:HMOPPOMedicaidState of NMNM Public Schools AuthorityNM Retiree AuthorityMedicare Supplement PlanSelf-FundedOtherPlease list the others hereComplaint TypeCo-PaysPremium PaymentReferral/ Prior AuthorizationTreatmentEmergency RoomMedical NecessityClaim DenialOut of NetworkOtherPlease List the others herePreviousNextDid you purchase your plan on the New Mexico Health Exchange (NMHIX)?YesNoHave you started the appeal process with your insurance company?YesNoIf yes, at what level is your complaint in the internal health plan's process?Medical DirectorInternal Panel ReviewExhausted Internal ReviewRequesting an External ReviewAre you requesting an expedited review? This type of review is required in “urgent care situation” where a health plan must make a fast decision about coverage because waiting could seriously affect the patient’s life or health, ability to recover, level of pain, or overall medical needs. It also includes cases where the treating physician reasonably requests an expedited review. Your treating physician’s note is required for this type of request. Are you requesting an expedited review?YesNoAre you represented by an attorney or an authorized representative acting on your behalf with your consent? (See Section 13.10.17.20 (G)(1) NMAC) If yes, ( Please check one)AttorneyAuthorized RepresentativeName of Attorney or Authorized RepresentativeFirstLastAttorney/Representative AddressAddress Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmailPreviousNextPlease give a brief summary of your complaint and attach copies of any documents that are part of your complaint:File Upload Drag & Drop Files, Choose Files to Upload You can upload up to 10 files. What do you feel is a fair resolution to this complaint?PreviousNextConsent to Release InformationBy checking the checkbox and entering your name you agree to authorize your insurance company to release all medical records, including nonpublic personal financial information, which are related to this complaint to the New Mexico Office of Superintendent of Insurance. I attest that the information provided in this application is true and accurate to the best of my knowledge.YesI understand that the New Mexico Office of Superintendent of Insurance will use this information to make a determination on my appeal and that the information will be kept confidential and will not be released to anyone else without my permission. I understand that if the New Mexico Office of Superintendent of Insurance does not act as an attorney for private citizens. This release is valid for one year.YesComplainant's Signature/Name *Date *PreviousSubmit
June 26, 2026 Bulletins MEDICAL MALPRACTICE PREMIUM REDUCTION AMENDED 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. […] Read More
June 12, 2026 Announcements NOTICE OF PRESCRIPTION DRUG PRICE TRANSPARENCY ANNUAL MEETING The Office of the Superintendent of Insurance will hold its annual public meeting to present and discuss the findings and recommendations contained in the 2025 Prescription Drug Price Transparency legislative report. The purpose of this meeting is to inform the public of the report’s contents and to provide an opportunity for public comments and questions. […] Read More
