New Mexico prompt pay law dental

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Under NMSA 1978, §59A-16-21.1; §59A-16-21(B), the New Mexico payment deadline is 30 days (electronic clean claim, health plans) and 45 days (manual clean claim, health plans). "A health plan shall provide for payment of interest on the plan's liability at the rate of one and one-half percent a month" on a clean claim not paid inside the 30- or 45-day window (§59A-16-21.1(B)). The remedy runs to eligible providers, defined as participating providers and providers the plan has credentialed, so an out-of-network dental office generally cannot use it. Keep the two New Mexico regimes apart: §59A-16-21(B) applies to insurers generally, gives them 45 days after required proof of loss, and sets interest at one and one-half times the prime lending rate, accruing from day 46 and inapplicable to claims in arbitration or litigation. Dental applicability: Two regimes and an unresolved edge. Section 59A-16-21.1 binds a "health plan," defined as a health maintenance organization, nonprofit health care plan, provider service network, or third-party payer — plain insurers are not on that list and instead owe the §59A-16-21(B) duty. Article 16's own scope section names "prepaid dental services organizations" among the entities the article reaches, which is the dental hook; but whether a stand-alone dental carrier is a "health plan" for §59A-16-21.1 turns on the undefined term "third-party payer," and the statute does not settle it. Medicaid managed care organizations appear nowhere in either section. A self-funded private-employer (ERISA) plan is generally beyond this statute's reach and runs on the federal claims-procedure clock instead — but that comes from the courts reading 29 U.S.C. § 1144, not from its text, and it is not categorical: a self-funded governmental or church plan is not an ERISA plan at all, § 1144(b)(6) leaves multiple employer welfare arrangements open to state insurance law, and nothing in § 1144 bars a state from reaching the third-party administrator or the network contract.