New Mexico Administrative Code
Title 13 - INSURANCE
Chapter 10 - HEALTH INSURANCE
Part 7 - FINANCIAL REPORTING REQUIREMENTS FOR HEALTH MAINTENANCE ORGANIZATIONS
Section 13.10.7.17 - POLICY-MAKING BODIES OF HMOS
Current through Register Vol. 35, No. 18, September 24, 2024
No later than one year after becoming operational as a certified HMO, an HMO shall either:
A. assure that at least one-third of the membership of the HMO's policy-making body are enrollees of the HMO and that they reside in, or in proximity to, the service area of the HMO. No enrollee who is a party-in-interest shall be included in the minimum one-third member representation on the policy-making body. Persons serving on the policy-making body are not prohibited from receiving payments of directors' fees or other similar fees, or interest and dividends derived from enrollment in an HMO cooperative.
B. create an advisory board to the policy-making body. At least one-third of the members of the advisory board must be enrollees of the HMO who meet the criteria of 13 NMAC 10.7.17.1 [now Subsection A of 13.10.7.17 NMAC]. The advisory board shall meet at least annually and at least annually shall file a report of its recommendations with the policy-making body of the HMO. The report and any minority reports shall be forwarded to the superintendent annually.
