PRIOR AUTHORIZATION DATA CALL

STATE OF NEW MEXICO OFFICE OF SUPERINTENDENT OF INSURANCE SUPERINTENDENT OF INSURANCE Alice T. Kane Main Office: 1120 Paseo de Peralta, Fourth Floor, Santa Fe, NM 87501 Satellite Office: 6200 Uptown Blvd NE, Suite 400, Albuquerque, NM 87110 Main Phone: (505) 827-4601 | Toll Free: (855) 4 - ASK - OSI www.osi.state.nm.us BULLETIN 2023-018 JUNE 30, 2023 TO: ALL MAJOR MEDICAL HEALTH INSURANCE CARRIERS, MEDICAID MANAGED CARE ORGANIZATIONS, AND HEALTH CARE PURCHASING ACT PLAN ADMINISTRATORS RE: PRIOR AUTHORIZATION DATA CALL Section 59A-22B-4 NMSA 1978 of the Prior Authorization Act (“the Act”) requires the Office of Superintendent of Insurance (“OSI”) to collect and issue a report on adherence to the Act and accompanying regulations. Accordingly, all entities subject to the Act shall complete and submit to OSI the data reporting form available for download on OSI’s website at https://www.osi.state.nm.us/pages/bureaus/mcb/resources/utilization-management by 12:00 p.m. on August 15, 2023, to Rolanda Pana at rolanda.pana@osi.nm.gov. Failure to timely submit a completed report is subject to the administrative penalties outlined in Section 59A-22B-4 NMSA 1978 of the Act. Any questions should be directed to Ms. Pana at her email address or via telephone at (505) 412-9651. Every subject entity shall report data 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 2022 plan year, as indicated in the reporting form. B U L L E T I N 2 0 2 3 - 0 1 8 P a g e | 2 Main Office: 1120 Paseo de Peralta, Fourth Floor, Santa Fe, NM 87501 Satellite Office: 6200 Uptown Blvd NE, Suite 400, Albuquerque, NM 87110 Main Phone: (505) 827-4601 | Toll Free: (855) 4 - ASK - OSI www.osi.state.nm.us ISSUED this 30th day of June, 2023. __________________________________ ALICE T. KANE Superintendent of Insurance