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Committee backs extending HMO financial exams from three to five years to meet national accreditation

March 12, 2025 | House of Representatives, Legislative, New Mexico


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Committee backs extending HMO financial exams from three to five years to meet national accreditation
The committee voted to advance the Health and Human Services committee substitute for House Bill 398, a department bill that would extend the period between deep financial examinations of health maintenance organizations from three to five years to align with national accreditation standards.

Alice Kane, the state superintendent of insurance, told the panel the substitute contains technical amendments to the insurance code to comply with National Association of Insurance Commissioners (NAIC) accreditation standards and clarifies two distinct pieces: group calculations for holding companies and stress testing for large licensees.

Anmol Tapia, financial analyst supervisor with the Office of Superintendent of Insurance, explained the change applies to the in-depth examination cadence, not the routine financial monitoring the office performs. “This is extending the HMO examination period. This is not necessarily saying that the HMOs domiciled within New Mexico are not going to be looked at on a quarterly basis as they are in general,” Tapia said. Quarterly filing review and day-to-day financial analysis would continue; the longer interval applies to the deeper, multi-issue examinations.

Committee members asked how New Mexico compares to other states and whether the change would reduce oversight. Tapia and Kane said five-year exam cycles are standard for many regulated entities nationally and that the superintendent’s office would continue quarterly reviews and follow up on red flags between examinations.

No public opposition appeared in the record. The committee recorded a do-pass recommendation for the Health and Human Services committee substitute for HB 398 by a 6–0 vote. Proponents said the change updates New Mexico’s rules to national practice while retaining ongoing financial surveillance of HMOs.

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Scribe from Workplace AI
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