A. In accordance with federal law, the secretary shall adopt and promulgate rules that allow a recipient to fill or refill a prescription for less than a thirty-day supply of a prescription drug and apply a prorated daily copayment or coinsurance, if applicable, for the fill or refill, if:
(1) the prescribing practitioner or the pharmacist determines the fill or refill to be in the best interest of the patient;
(2) the recipient requests or agrees to receive less than a thirty-day supply of the prescription drug; and
(3) the reduced fill or refill is made for the purpose of synchronizing the recipient's prescription drug fills.
B. Medical assistance coverage shall not:
(1) deny coverage for the filling of a chronic medication when the fill is made in accordance with a plan to synchronize multiple prescriptions for the recipient pursuant to Subsection A of this section established among the department or the recipient's managed care plan, the prescribing practitioner and a pharmacist. The medical assistance coverage shall allow a pharmacy to override any denial indicating that a prescription is being refilled too soon for the purposes of medication synchronization; and
(2) prorate a dispensing fee to a pharmacy that fills a prescription with less than a thirty-day supply of prescription drug pursuant to Subsection A of this section. The medical assistance coverage shall pay in full a dispensing fee for a partially filled or refilled prescription for each prescription dispensed, regardless of any prorated copayment or coinsurance that the recipient may pay for prescription synchronization services.
History: Laws 2015, ch. 65, § 2.
Effective dates. — Laws 2015, ch. 65 contained no effective date provision, but, pursuant to N.M. Const., art. IV, § 23, was effective June 19, 2015, 90 days after the adjournment of the legislature.
Structure New Mexico Statutes
Chapter 27 - Public Assistance
Article 2 - Public Assistance Act
Section 27-2-3 - Standard of need; income determination.
Section 27-2-4 - Eligibility requirements.
Section 27-2-6.1 - Supplemental postnatal assistance.
Section 27-2-7 - General assistance program; qualifications and payments.
Section 27-2-7.1 - Eligible person entitled to information.
Section 27-2-9 - Payment for hospital care.
Section 27-2-9.1 - Administration of shelter care supplement.
Section 27-2-10 - Food stamp program.
Section 27-2-11 - Scope of assistance programs.
Section 27-2-12 - Medical assistance programs.
Section 27-2-12.2 - Medical assistance program; eligibility of married individuals.
Section 27-2-12.6 - Medicaid payments; managed care.
Section 27-2-12.8 - Mammograms for medicaid recipients.
Section 27-2-12.9 - Medicaid; personal spending allowances; increases.
Section 27-2-12.10 - Clinical nurse specialists.
Section 27-2-12.11 - Prescription drug waiver program; purpose; eligibility.
Section 27-2-12.12 - Human services department; managed care contract credentialing provisions.
Section 27-2-12.13 - Medicaid reform; program changes.
Section 27-2-12.14 - Brain injury; services authorized.
Section 27-2-12.20 - Crisis triage center; medical assistance reimbursement.
Section 27-2-12.21 - Medical assistance; pharmacy benefits; prescription synchronization.
Section 27-2-12.24 - Medical assistance; plan of care; participation required.
Section 27-2-12.25 - Prior authorization for gynecological or obstetrical ultrasounds prohibited.
Section 27-2-12.28 - Medical assistance; autism spectrum disorder.
Section 27-2-12.30 - Pharmacist prescriptive authority services; reimbursement parity.
Section 27-2-12.31 - Heart artery calcium scan coverage.
Section 27-2-13 - Conflict in federal and state laws.
Section 27-2-14 - Continuing effect of regulations and standards.
Section 27-2-15 - Cooperation with United States.
Section 27-2-16 - Compliance with federal law.
Section 27-2-17 - Custodian of funds.
Section 27-2-18 to 27-2-20 - Repealed.
Section 27-2-21 - Assistance not assignable.
Section 27-2-23 - Third party liability.
Section 27-2-24 - [Federal government entitled to share recovery.]
Section 27-2-25 - Funeral expenses.
Section 27-2-26 - Money received from other sources; duty and liability of funeral director.
Section 27-2-27 - Single state agency; powers and duties.
Section 27-2-28 - Liability for repayment of public assistance.
Section 27-2-29.1 - Compensation under contingent fee contracts; suspense fund created.
Section 27-2-30 - [Enforcement of support;] orders.
Section 27-2-31 - Judgments and proceeds.
Section 27-2-32 - Duty of agencies to cooperate.
Section 27-2-34 - Limitations of act.
Section 27-2-35 to 27-2-40 - Repealed.
Section 27-2-41 - Short title.
Section 27-2-42 - Legislative findings; purpose.
Section 27-2-43 - Definitions.
Section 27-2-44 - Indigent catastrophic illness hospital fund created.
Section 27-2-45 - Hospitals; claims for payment.