A. Every health maintenance organization shall annually, on or before the first day of March, file a report, verified by at least two principal officers, with the superintendent covering the preceding calendar year.

Terms Used In New Mexico Statutes 59A-46-9

  • Contract: A legal written agreement that becomes binding when signed.

B. The report shall be on forms prescribed by the superintendent and shall include: (1)     a financial statement of the organization prepared pursuant to forms prescribed by the superintendent, including its balance sheet and receipts and disbursements for the preceding year;

(2)     any material changes in the information submitted pursuant to Subsection C of Section 59A-46-3 N.M. Stat. Ann.;

(3)     the number of persons enrolled during the year and the number of enrollees as of the end of the year; and

(4)     such other reasonable information materially relating to the performance of the health maintenance organization as is necessary to enable the superintendent to carry out the superintendent’s duties under the Insurance Code.

C. In addition, the health maintenance organization shall file by the dates indicated: (1)     on or before March 1, an annual statement in accordance with the requirements of Section 59A-5-29 N.M. Stat. Ann. and a risk-based capital report in accordance with the requirements of Section 59A-5A-3 N.M. Stat. Ann.;

(2)     a list of the providers who have executed a contract that complies with Subsection E of Section 59A-46-13 N.M. Stat. Ann. on or before March 1; and

(3)     a description of the grievance procedures and the total number of grievances handled through such procedures, a compilation of the causes underlying those grievances and a summary of the final disposition of those grievances, on or before March 1.

D. The superintendent may require such additional reports as are deemed necessary and appropriate to enable the superintendent to carry out the superintendent’s duties under the Health Maintenance Organization Law.