SANTA FE, N.M. — New Mexico state insurance regulators are making it clear that emergency medical services cannot be billed at higher rates when patients are treated outside an insurance provider’s network of doctors and hospitals.
The Office of the Superintendent of Insurance issued a bulletin this week to health insurance companies in response to public concerns about patients who receive surprise bills for services outside of an insurance provider’s network.
The bulletin said insurers cannot bill policyholders for balances that accrue from out-of-network care during medical emergencies, clarifying provisions of current law.
The guidance from Insurance Superintendent John Franchini does not apply to the treatment of non-emergency conditions at emergency facilities.
Agency polling shows that about one-third of patients statewide have received large surprise bills over the past two years for out-of-network care.