New
Mexico Register / Volume XXXI, Issue 9 / May 5, 2020
NOTICE OF PROPOSED RULEMAKING
NOTICE IS HEREBY GIVEN that the Superintendent of Insurance
(Superintendent), pursuant to the Insurance Code, Section 59A-l -1 et
seq. NMSA 1978 (“Insurance Code”) and 13.1.4 NMAC, proposes to amend 13.10.27 NMAC, UNIFORM DEFINITIONS AND STANDARDIZED
METHODOLOGIES FOR CALCULATING THE MEDICAL LOSS RATIO.
PURPOSE AND
SUMMARY OF THE PROPOSED RULES The purpose of this rule is to clarify
statutory requirements that insurers make reimbursement for direct services at
certain levels across all product lines by providing guidance and establishing
uniform definitions and standardized methodology for calculating the
minimum medical loss ratio.
STATUTORY AUTHORITY: NMSA 1978, Sections 59A-1-1 et seq.
Copies
of the Notice of Proposed Rulemaking and proposed rules are available by
electronic download from the OSI website (https://www.osi.state.nm.us/index.php/idms/)
or the
New Mexico Sunshine portal. There are two versions of rules being proposed; (1)
A proposal from Staff with proposed revisions to the entire rule, and (2) a
proposal from Blue Cross Blue Shield of New Mexico for a revision to Subsection
G of Section 8 of 13.10.27 NMAC.
OSI
will hold a public video/telephonic hearing on the proposed rules on June 15,
2020 at 10:00 a.m.,
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The
Superintendent designates R. Alfred Walker to act as the hearing officer for
this rulemaking. Oral comments will be
accepted at the video/telephonic hearing from members of the public and any
interested parties.
Written comments and proposals will be
accepted through 4:00 pm on the day of the public hearing, or the last day of
the public hearing if the public hearing extends for more than one day. Responses to written comments or oral
comments will be accepted through 4:00 pm on June 25, 2020. Comments may be submitted via email to
OSI-docketfiling@state.nm.us or may be filed by sending original copies to:
OSI
Records and Docketing, NM Office of Superintendent of Insurance
1120
Paseo de Peralta, P.O. Box 1689, Santa Fe, NM 87504-1689
Docket No.:
19-00057-RULE-LH
IN
THE MATTER OF THE PETITION OF BLUE CROSS BLUE SHIELD OF NEW MEXICO FOR
AMENDMENT OF THE UNIFORM DEFINITIONS AND STANDARDIZED METHODOLOGIES FOR
CALCULATING THE MEDICAL LOSS RATIO RULE.
Only signed statements, proposals or comments will be
accepted. Scanned or electronic
signatures conforming to federal and state court requirements will be accepted
with the understanding that if there is any dispute regarding a signature, OSI
reserves the right to require that original signatures be provided to verify
the electronic or facsimile signature.
All filings must be received between the hours of 8:00 a.m. and 4:00
p.m. Monday through Friday except on state holidays. Any filings after 4:00 will be filed to the
docket the next business day.
SPECIAL NEEDS: Any person with a disability who is in need
of a reader, amplifier, qualified sign language interpreter, or other auxiliary
aid or service to attend or participate in the hearing should contact Melissa
Gutierrez at 505-476-0333 ten (10) business days prior to the hearing.
The Superintendent will
consider all oral comments, and will review all timely submitted written
comments and responses.
DONE
AND ORDERED this 5th day of May 2020
/S/RUSSELL
TOAL