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About Us

The Managed Health Care Bureau of the Insurance Division assists the Superintendent in administering and enforcing the New Mexico Insurance Code, Patient Protection and Insurance Division rules related to commercial managed health care insurance in New Mexico.

The Bureau’s key focus is to assist managed health care consumers and enrollees in understanding their rights to appeal coverage denials of requested health care services under a managed health care plan or PPO product. Such appeals and complaints are rights afforded to every commercial managed health care enrollee under the New Mexico Patient Protection Act.

The Bureau also promotes the education of these rights by conducting outreach presentations throughout New Mexico. Our staff will come and deliver outreach presentation to your group.

We also assist health care providers with certain issues related to managed health care insurer operations and specifically, the timely payment of clean claims.