New Mexico Register / Volume XXXV,
Issue 16 / August 27, 2024
NOTICE OF
PROPOSED RULEMAKING
NOTICE IS HEREBY GIVEN that the Office of Superintendent
of Insurance (OSI or Superintendent), Managed Health Care Bureau (MHCB) will
hold a public hearing in person, via video conference and telephone conference regarding
proposed amendments to 13.10.17 NMAC, Grievance Procedures. This hearing will commence on Friday, September
27, 2024, at 10:00 a.m.
PURPOSE
OF THE PROPOSED RULE: The
purpose of this rulemaking is to address amendments to 13.10.17 NMAC, Grievance
Procedures. The proposed amendments to
13.10.17 NMAC address: 1) exemptions
in the scope of the rule in Subsection B of 13.10.17.2 NMAC; 2) assistance
to grievants in Subsection C of 13.10.17.9 NMAC; 3)
the assistance required to be given to insured from the health care insurer and
from the MHCB and to explain the role of the MHCB in Paragraph (4) of
Subsection A of 13.10.17.10 NMAC; 4) the extension of the internal panel
review from five to 15 days in Paragraph (7) of Subsection B of 13.10.17.15
NMAC; 5) eligibility requirements for grievants
subject to the New Mexico Health Care Purchasing Act for an external review
through OSI after an internal review by the health care insurer and review
board in Subsection C of 13.10.17.18 NMAC; 6) the details of initiation
of an expedited review in Subsection A of 13.10.17.21 NMAC; 7) the IRO number
of clinical reviewers in Subsection C of 13.10.17.23 NMAC and Paragraph (3) of
Subsection D of 13.10.17.22 NMAC; 8) amendments to the Superintendent’s
hearing procedures in Subsection H of 13.10.17.24 NMAC; 9) updates to contact
information in Subsection C of 13.10.17.15 NMAC, Subsection B of 13.10.17.21
NMAC , and Subsection A of 13.10.17.31 NMAC; and 10) extends the time available
for review of an administrative grievance by the Superintendent from 45 days to
60 days in 13.10.17.33 NMAC.
STATUTORY AUTHORITY: Sections 59A-1-16, 59A-2-8,
59A-2-9, 59A-15-16, 59A-16-3, 59A-16-11, 59A-16-12, 59A-16-12.1, 59A-16-20,
59A-16-22, 59A-19-4, 59A-19-6, 59A-22A-7, 59A-46-10, 59A-46-11, 59A-57-1
through 59A-57-11 NMSA 1978.
TO ATTEND THE HEARING BY
ELECTRONIC VIDEO CONFERENCE VIA MS TEAMS MEETING:
Please copy the link below into
your browser to get to the meeting:
https://teams.microsoft.com/dl/launcher/launcher.html?url=%2F_%23%2Fl%2Fmeetup-join%2F19%3Ameeting_ZGMxYzhmNmYtNjhlOS00MmFkLTljMDktYTdlZGM3NmJiNWFk%40thread.v2%2F0%3Fcontext%3D%257b%2522Tid%2522%253a%252204aa6bf4-d436-426f-bfa4-04b7a70e60ff%2522%252c%2522Oid%2522%253a%252292f8d9f0-87c0-44c3-9357-ba0eb6121f10%2522%257d%26anon%3Dtrue&type=meetup-join&deeplinkId=e70f1cfc-f2f1-4347-ad03-98d1067de0f8&directDl=true&msLaunch=true&enableMobilePage=true&suppressPrompt=true
TO ATTEND VIA TELEPHONE: +1 505-312-4308 Phone Conference ID: 855675742#
PUBLIC COMMENT: The Superintendent designates Clifford Rees as the hearing officer for this hearing. Oral comments will be accepted at the public hearing from members of the public and other interested parties in-person or electronically. Copies of the Notice of Proposed Rulemaking and proposed rules are available by electronic download from the OSI eDocket (https://edocket.osi.state.nm.us/case-view/5972)or by requesting a copy by calling Gurrattanpal “Mickey” Singh at: 505-231-9013. Any copies of the Notice of Proposed Rulemaking, proposed rules, and any updates concerning the hearing date, time, or location will be available by visiting the OSI website at: https://www.osi.state.nm.us/pages/bureaus/legal/resources/laws-rules or on the Sunshine Portal at: https://statenm.my.salesforce-sites.com/public/SSP_RuleHearingSearchPublic (from the “Agency” drop down menu, select “Office of Superintendent of Insurance”)
Written comments will be
accepted through 4:00 p.m. on Friday, September 27, 2024. Responses to written
or oral comments delivered at the hearing will be accepted through 4:00 p.m. on
Monday, October 8, 2024.
All comments shall be filed
electronically through the OSI
eDocket. Please copy the following link
into your browser to get to the eDocket: https://edocket.osi.state.nm.us/case-view/5972
Written comments may be sent
via U. S. mail to:
OSI Records and Docketing
NM Office of
Superintendent of Insurance
P.O. Box 1689, Santa Fe, NM 87504-1689
Written comments must be
received by OSI and stamped as accepted between the hours of 8:00 a.m. and 4:00
p.m. Monday through Friday except on state holidays. The Superintendent will
consider all oral comments and will review and consider all timely submitted
written comments and written responses. For help submitting a filing, please
contact osi-docketfiling@state.nm.us. The below docket number and title must be indicated on
all written comments submitted to the OSI:
Docket No. 2024-0060 – Please copy the following link into your browser to get to the
eDocket: https://edocket.osi.state.nm.us/case-view/5972
IN THE MATTER OF
AMENDMENTS TO 13.10.17 NMAC, GRIEVANCE
PROCEDURES
SPECIAL NEEDS: Any person with a
disability requiring special assistance to participate in the hearing should
contact Andrea Padilla, at 505-531-7171 no later than ten (10) business days
prior to the hearing.