NM| In Bulletin 2025-003 from the New Mexico Office of Superintendent of Insurance outlines updated requirements for health care carriers regarding the Surprise Billing Protection Act. The document details new data reporting expectations for plan years 2021, 2022, and 2024, including expanded data fields and revised submission protocols to enhance oversight of out-of-network billing practices and assess the Act’s effectiveness.
Key Points:
- Carriers must use a revised data call template that includes expanded definitions, new data fields (such as percent of Medicare claims paid at the Surprise Billing Rate), and automated totals to improve data accuracy and validation.
- Reports for plan years 2021 and 2022 are now required (despite no prior collection), with a submission deadline of October 1, 2025, while the 2024 report is due by September 1, 2025; all filings must follow specific naming and submission conventions.
- Failure to submit complete and accurate information by the deadlines may result in penalties, and carriers are encouraged to contact the Office for any clarifications regarding compliance requirements.