Lovelace may go out of network for Blue Cross Blue Shield

In Brief

Lovelace providers may be out-of-network for Blue Cross Blue Shield NM patients as soon as June 1.Negotiations between the health care group and BCBSNM are ongoing.Both Lovelace and BCBSNM said emergency services will not be impacted.Some patients, such as those who are pregnant or those with pre-scheduled surgeries, may qualify for continuity of care services.

ALBUQUERQUE, N.M. – Lovelace Health System, one of the Albuquerque metro’s three major hospital and health care networks, may soon be designated as an out-of-network provider for one New Mexico’s largest health insurers.

Lovelace Health System recently sent a letter to patients who use Blue Cross Blue Shield of New Mexico, warning them of the potential disruption.

What Lovelace is saying

In the Lovelace letter, the provider said it is “working in good faith to achieve an agreement” with BCBSNM.

In a statement to KOB 4, a spokesperson for Lovelace said “BCBSNM reimburses Lovelace significantly below what it pays other health systems in New Mexico. Like health systems across the country, we are navigating significant inflationary pressures and rising costs for staffing, supplies and technology, along with higher administrative costs required to resolve delayed or denied claims. To continue delivering the level of care our community depends on, we are asking for reimbursement and payment terms that are consistent with what BCBSNM already provides to other systems—not more.”

The statement went on to say “Importantly, this negotiation is not just about rates. It is also about how claims for medically necessary care are being handled. We continue to see denials of pre‑authorized services, along with repeated delays in processing and paying covered claims. These patterns create uncertainty for patients, add unnecessary waste to the healthcare system, and place additional strain on the care experience for patients and providers alike.”

The letter Lovelace sent to patients asked them to contact BCBSNM to and urge the insurance provider protect in-network access.

Lovelace also reassured patients in its letter that emergency services will remain at in-network rates.

The letter sent by Lovelace Health SystemWhat BCBSNM is saying

Blue Cross Blue Shield of New Mexico published a website regarding the potential loss of Lovelace from its network.

At the top of the webpage, BCBSNM said it was Lovelace that wants to back out.

“Lovelace Health System informed us that they intend to leave our networks on June 1, 2026. We’re working closely with Lovelace leadership and hope to sign new contracts that will keep them in our networks before then,” the website read. 

BCBSNM listed several plans that would potentially go out-of-network, including:

ParPlanPPOPOSHMOBlue Advantage HMOSMBlue PreferredSMBlue Community HMOSMBlue Cross Medicare Advantage (PPO)SM  Blue Cross Medicare Advantage (HMO)SMTurquoise Care

BCBSNM noted several hospitals and clinics affiliated with Lovelace could possibly become out-of-network providers, such as the New Mexico Heart Institute.

What this means for patients already receiving care

Some patients, including those who are pregnant or being treated for a disability, may be able to qualify as a continuity of care patient.

Both Lovelace and BCBSNM referenced this option on their websites.

Continuity of care means patients can still receive care at Lovelace with in-network benefits.

On its website, BCBSNM told patients to call the number on their member ID card to see if they qualify.

There is also a Request for Continued Access to Providers form.

Similarly, BCBSNM is asking members who have a procedure scheduled at a Lovelace facility on or after June 1, 2026 to call the number on their member ID card.

Patients who have a procedure performed before June 1, 2026, but stay in the hospital past June 1 may also be covered at the in-network level.

What this means for doctors and primary care

With a doctor shortage, it is no secret that finding primary care can be a challenge in New Mexico.

BCBSNM said if a primary care provider is directly employed by Lovelace and leaves the network, the insurance carrier will help members find a new provider.

After June 1, if a member has not selected a new primary care provider, BCBSNM said it will choose one and issue a new member ID card.

BCBSNM points out that some primary care providers may have privileges at other hospitals. BCBSNM also said it is offering doctors who only have privileges at Lovelace facilities the ability to send patients to other in-network facilities.

The complicated web of notifications extends to providers, too. The insurer also said it will let doctors know of the possible contract expiration help them transition procedures with other in-network doctors, hospitals or facilities.

What this means for hospitals

Lovelace is one of the three major hospital systems in the Albuquerque metro, alongside Presbyterian and UNM Health. Many BCBSNM plans consider Presbyterian to be out-of-network for metro area residents. Losing Lovelace would leave UNM Health as the only hospital system in the metro area within network.

While both BCBSNM and Lovelace have said emergency care will not be impacted, non-emergency services will go out-of-network.

Further questions

Further information from Blue Cross Blue Shield of New Mexico is available in this FAQ.

Further information from Lovelace Health System can be found on this website.