What are you looking for? License Status VerificationAnnual/Quarterly ChecklistsFraud AssessmentsCompany LicensingRenewalsStatutory DepositsFeesApplying for Admission & ApplicationsLife 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 Offense 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) Instructions and Reporting Templates for QHPs Only CMS Network Adequacy Standards OSI QHP Guidance for Carriers 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
September 30, 2026 Bulletins REQUESTING CONFIDENTIALITY OF A RECORD SUBMITTED TO OSI BULLETIN 2026-011: This Bulletin 2026-011 replaces former Bulletin 2024-018, which expires on October 1, 2026. Also, this Bulletin replaces a portion of the “Confidentiality Requests” paragraph on page 3 of Bulletin 2025-0111 as expressly discussed below. In accordance with the Insurance Code and to align with OSI’s mission to regulate the business of insurance, health insurance & […] Read More
August 11, 2026 Announcements 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 […] Read More
