Sat Mar 8 4:59PM - 13 days, 18 hours left in session
| Sponsor | ||
|---|---|---|
| Sen. Linda M. López | 11 | Bernalillo |
| Status | |||
|---|---|---|---|
| SHPAC | [Referred, not scheduled] | ||
| STBTC | |||
This is the official nmlegis action history. I'm doing my best to translate the LONG/WEIRD-STRING to something less gibberishy. And before you ask, no, the "Legis Day" number has no mapping to the real world.
Actions: [8] SHPAC/STBTC-SHPAC
| Legis Day | Action | Details |
|---|---|---|
| 8 | referred | SHPAC/STBTC |
| 8 | sent | SHPAC |
This table shows bill actions detected on Ed's system, using heuristics that may not be 100% accurate and which may not reflect the "official" nmlegis chronology. It is probably more than you care to know.
| Feb 20 | filed: [Prefiled by Linda M. López; not yet on nmlegis] |
| [new] | |
| sent to SHPAC | |
| title: '[prefiled by Linda M. López; Not Yet on Nmlegis]' -> 'Health Care Provider Reimbursements' | |
| actions: 'SPREF' -> '[8] SHPAC/STBTC-SHPAC' | |
| new sponsor: Linda M. López |
SENATE BILL 512
57th legislature - STATE OF NEW MEXICO - first session, 2025
INTRODUCED BY
Linda M. López
AN ACT
RELATING TO INSURANCE; AMENDING THE SURPRISE BILLING PROTECTION ACT TO CHANGE THE METHOD FOR CALCULATING HEALTH CARE PROVIDER REIMBURSEMENT.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
SECTION 1. Section 59A-57A-13 NMSA 1978 (being Laws 2019, Chapter 227, Section 13) is amended to read:
"59A-57A-13. PROVIDERS--REIMBURSEMENT FOR A SURPRISE BILL.--
A. For services provided pursuant to Section [3 or 4 of the Surprise Billing Protection Act] 59A-57A-3 or 59A-57A-4 NMSA 1978, a health insurance carrier shall directly reimburse a nonparticipating provider for care rendered the surprise bill reimbursement rate for services.
B. The surprise bill reimbursement rate [shall be calculated using claims data reflecting the allowed amounts paid for claims paid in the 2017 plan year] related to a specified service shall be determined based on claims data that reflects the reimbursement amount for that service in the calendar year that is two years prior to the year in which the service was provided.
C. As used in this section, "surprise bill reimbursement rate" means the sixtieth percentile of the allowed commercial reimbursement rate for the particular health care service performed by a provider in the same or similar specialty in the same geographic area, as reported in a benchmarking database [maintained by a nonprofit organization] specified by the superintendent after consultation with health care sector stakeholders; provided that no surprise bill reimbursement rate shall be paid at less than one hundred fifty percent of the [2017] approved and published medicare reimbursement rate for the applicable health care service provided [D. The nonprofit organization shall be conflict-free and unaffiliated with any stakeholder in the health care sector] in the calendar year prior to the year the service was provided."
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