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 [59A-2-9.8 NMSA 1978] and 3 [61-11-6.2 NMSA 1978] 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.
History: Laws 2013, ch. 170, § 4.
Effective dates. — Laws 2013, ch. 170 contained no effective date provision, but, pursuant to N.M. Const., art. IV, § 23, was effective June 14, 2013, 90 days after the adjournment of the legislature.
Structure 2021 New Mexico Statutes
Chapter 26 - Drugs and Cosmetics
Article 1 - General Provisions
Section 26-1-3 - Prohibited acts.
Section 26-1-3.2 - Prescription drug donation.
Section 26-1-4 - Power to enjoin violations.
Section 26-1-5 - Penalty; exemptions.
Section 26-1-7 - Attorney general or district attorney to institute prosecutions.
Section 26-1-8 - Minor violations of act; warnings authorized.
Section 26-1-9 - Addition of poisonous or deleterious substances; color additives.
Section 26-1-10 - Drug or device adulteration.
Section 26-1-11 - Drug or device; misbranding.
Section 26-1-12 - False advertising.
Section 26-1-13 - Packaging and labeling requirements; proprietary preparations.
Section 26-1-14 - New drugs and devices; prerequisites to sale, delivery or giving away; exceptions.
Section 26-1-15 - Dangerous drugs; veterinary use; limitations.
Section 26-1-16 - Dangerous drugs; conditions for sale; prescription refilling; limitations.
Section 26-1-17 - Testing laboratory.
Section 26-1-18 - Promulgating regulations; procedure.
Section 26-1-18.1 - Prescription drug prior authorization protocols.
Section 26-1-19 - Power to make inspections and secure samples.
Section 26-1-21 - Power of board to publish reports and disseminate information.
Section 26-1-22 - Unlawful means of obtaining dangerous drugs enumerated.
Section 26-1-23 - False statements; false pretenses; forgery of labels or prescriptions prohibited.
Section 26-1-24 - Cosmetics; misbranding.