• Provider Grievance

The Grievance Procedures, as outlined in 13.10.16.8 NMAC states a carrier shall adopt and implement a provider grievance plan that complies with this rule. This rule does not preclude a carrier and provider from addressing or resolving a concern through any other process agreed on between them, but no such alternative process shall preclude a provider from presenting a grievance through a process that complies with this rule.

OSI regulates member and provider grievances for major medical health insurance plans. See details below on OSI’s provider grievance regulatory requirements.

Guidance Chart

Regulations

Bulletins and News

Please check back frequently for updates

Provider Complaint Form

Recent News

Get the latest information about rule changes, legislation, industry information and consumer news.

Read All OSI News

New Mexico Annual Appointment Renewal 2027

DATE: November 4th, 2026 TO: Insurance Companies with New Mexico Agent Appointments SUBJECT: New Mexico Agent Appointment Renewal Invoices for 2027 The New Mexico Office of the Superintendent of Insurance (OSI) will process all company appointments electronically through the National Insurance Producer Registry (NIPR). The appointment renewal invoice will include all resident/nonresident appointment renewals. All […]

Read More

NEW MEXICO ANNOUNCES RATES FOR 2027 SMALL GROUP HEALTH INSURANCE MARKET

Contact: Viara IanakievaEmail: Viara.Ianakieva@osi.nm.gov Santa Fe, NM – The New Mexico Office of Superintendent of Insurance (OSI) has approved 2027 health insurance premium rates for the small group health insurance market. As of March 2026, over 31,000 New Mexicans were enrolled in a small group plan. The average increase across small group plans is 19.8%. […]

Read More