While the new federal surprise billing law called the No Surprises Act went into effect on Jan. 1, New Mexico Superintendent of Insurance Russell Toal wants to remind people the state’s own surprise billing law has been around since 2020.
“For two years, New Mexico’s Surprise Billing Protection Act has been shielding many New Mexicans from the serious financial impact of surprise medical bills,” Toal said in a press release from the state’s Office of Superintendent of Insurance. “Our law protects people from these costly bills just like the federal law does.”
A surprise bill is when a person, through no fault of their own, unknowingly or unavoidably receives health care services from providers outside their insurance company’s network and then is billed directly for that care.
According to the release, New Mexico’s surprise billing law and the federal law protect people by limiting the financial obligation for a surprise bill to the deductible, coinsurance or copayment amounts they would normally owe for the same services received in network.
OSI rules require health insurance companies to notify enrollees when the company has processed a claim subject to the surprise billing law and to explain the enrollee’s rights under the law, per the release.
“We are serious about enforcing this law and are here to help if someone gets a surprise bill,” Toal said in the release.
Individuals who have health insurance and believe they have received a surprise billing should first contact their insurance company. If the issue is not resolved, individuals can submit a complaint to the OSI’s Managed Health Care Bureau at osi.state.nm.us/index.php/managed-healthcare-complaint/ or call 855-427-5674.