NM| The New Mexico Office of Superintendent of Insurance issued Bulletin 2025-009 to clarify requirements for health insurers and HMOs regarding immunization coverage for the 2025 and 2026 plan years. Insurers must provide immunization coverage based on Advisory Committee on Immunization Practices (ACIP) guidelines in effect at the time their rates were filed and approved, regardless of later ACIP changes during those plan years. Any future changes to ACIP guidance affecting coverage should only be applied prospectively, beginning with the 2027 plan year.
Key Points:
- Immunization coverage for 2025 and 2026 must follow the ACIP guidelines in place at the time rates were submitted and approved, not retroactively adjusted if ACIP changes during the plan year.
- Health insurers and HMOs cannot reduce or alter immunization coverage mid-plan year based on new ACIP guidance; updates are only allowed starting in 2027.
