N.M. Stat. § 26-1-18.1
This is the official text of N.M. Stat. § 26-1-18.1, part of New Mexico’s Stat — part of the compiled statutory law of New Mexico, published by the state as "Stat." Browse the sections below, each linked to its official government source.
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§ 26-1-18.1. Prescription drug prior authorization protocols
Official statutory text
A. After January 1, 2014, a prescribing practitioner seeking prior authorization from a health insurer may use the uniform prior authorization form developed pursuant to Sections 2 and 3 of this 2013 act.
B. As used in this section:
(1) “ health insurer ” means a health insurer; a nonprofit health service provider; a health maintenance organization; a managed care organization; or a provider service organization. “Health insurer” does not include:
(a) a person that delivers, issues for delivery or renews an individual policy intended to supplement major medical group-type coverages such as medicare supplement, long-term care, disability income, specified disease, accident-only, hospital indemnity or other limited-benefit health insurance policy;
(b) a physician or a physician group to which a health insurer has delegated financial risk for prescription drugs and that does not use a prior authorization process for prescription drugs; or
(c) a health insurer or its affiliated providers if the health insurer owns and operates its pharmacies and does not use a prior authorization process for prescription drugs; and
(2) “ prescribing practitioner ” means a person that is licensed or certified to prescribe and administer drugs that are subject to the New Mexico Drug, Device and Cosmetic Act.
B. As used in this section:
(1) “ health insurer ” means a health insurer; a nonprofit health service provider; a health maintenance organization; a managed care organization; or a provider service organization. “Health insurer” does not include:
(a) a person that delivers, issues for delivery or renews an individual policy intended to supplement major medical group-type coverages such as medicare supplement, long-term care, disability income, specified disease, accident-only, hospital indemnity or other limited-benefit health insurance policy;
(b) a physician or a physician group to which a health insurer has delegated financial risk for prescription drugs and that does not use a prior authorization process for prescription drugs; or
(c) a health insurer or its affiliated providers if the health insurer owns and operates its pharmacies and does not use a prior authorization process for prescription drugs; and
(2) “ prescribing practitioner ” means a person that is licensed or certified to prescribe and administer drugs that are subject to the New Mexico Drug, Device and Cosmetic Act.
Status: in_force
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