PRIOR AUTHORIZATION DATA CALL

STATE OF NEW MEXICO OFFICE OF SUPERINTENDENT OF INSURANCE SUPERINTENDENT OF INSURANCE Russell Toal DEPUTY SUPERINTENDENT Jennifer A. Catechis Main Office: 1120 Paseo de Peralta, Room 428, Santa Fe, NM 87501 Satellite Office: 6200 Uptown Blvd NE, Suite 400, Albuquerque, NM 87110 Main Phone: (505) 827-4601 | Satellite Phone: (505) 322-2186 | Toll Free: (855) 4 - ASK - OSI www.osi.state.nm.us BULLETIN 2021-008 June 8, 2021 TO: EVERY A HEALTH MAINTENANCE ORGANIZATION, NONPROFIT HEALTH CARE PLAN, PROVIDER SERVICE NETWORK, MEDICAID MANAGED CARE ORGANIZATION, THIRD-PARTY PAYER, OR THE UTILIZATION REVIEW AGENT OF ANY SUCH PERSON RE: PRIOR AUTHORIZATION DATA CALL Section 59A-22B-4 NMSA 1978 of the Prior Authorization Act (“the Act”) requires the New Mexico Office of Superintendent of Insurance (“OSI”) to issue an annual report concerning prior authorization market conduct. To facilitate preparation of that report, the OSI directs every entity subject to the Prior Authorization Act to complete and submit to OSI the data reporting form available at: Prior-Authorization-Data-Call.xlsx Every subject entity shall report data separately for fully-insured lines of major medical business, Medicaid coverage, including fee for service coverage, and coverage provided under the Health Care Purchasing Act. Reporting for fully-insured lines of major medical business shall be aggregated for all markets. Only include data from the 2020 plan year. Please submit the completed form to Rolanda Paña at rolanda.pana@state.nm.us by 12:00 p.m. MST on August 2, 2021. Any questions should also be directed to Ms. Paña. ISSUED this 8th day of June, 2021 __________________________________ RUSSELL TOAL Superintendent of Insurance