A. The board may establish a prescription drug program, in whole or in part, including a pilot or phase-in program, to offer selected eligible persons the ability to purchase prescription drugs. The board may establish varying levels of eligibility and cost-sharing criteria as needed for selected eligible persons and, if established, shall ensure that cost-containment mechanisms are included in the program.
B. The board may establish the cost-sharing amounts payable by a person enrolled in the prescription drug program, including the premium, deductible, coinsurance, co-payment and other out-of-pocket expenses.
C. If the board establishes a prescription drug program, the board shall establish the assessments pursuant to Section 59A-54-10 NMSA 1978.
D. If the board establishes a prescription drug program, the assessment for a pool member shall be determined in the same manner as provided in this section provided that a pool member shall be allowed a fifty percent credit for the prescription drug program assessment on the premium tax return for that member.
E. The board may issue a pool prescription drug program benefit policy for a person who is over the age of sixty-five and unable to purchase or is ineligible for a similar prescription drug program. The board may issue a pool prescription drug program benefit policy for a person who is eligible for a state-funded or state-operated low-income pharmacy benefit program.
F. If the board establishes a prescription drug program, the board shall cooperate with other state and federal prescription drug initiatives.
History: Laws 2003, ch. 396, § 1.
Effective dates. — Laws 2003, ch. 396 contained no effective date provision, but, pursuant to N.M. Const., art. IV, § 23, was effective June 20, 2003, 90 days after adjournment of the legislature.
Structure New Mexico Statutes
Article 54 - Medical Insurance Pool
Section 59A-54-1 - Short title.
Section 59A-54-3 - Definitions.
Section 59A-54-4 - Pool created; board.
Section 59A-54-5 - Plan of operation.
Section 59A-54-6 - Notice of pool.
Section 59A-54-7 - Board; powers and duties.
Section 59A-54-7.1 - Prescription drug program; cost-sharing.
Section 59A-54-7.2 - Expansion of programs pursuant to federal law.
Section 59A-54-8 - Examination.
Section 59A-54-9 - Policy forms.
Section 59A-54-10 - Assessments.
Section 59A-54-11 - Pool administrator; selection; duties.
Section 59A-54-12 - Eligibility; policy provisions.
Section 59A-54-14 - Deductibles; coinsurance; maximum out-of-pocket payments.
Section 59A-54-15 - Dependent family member required coverage; employer responsibilities.
Section 59A-54-16 - Pool policy.
Section 59A-54-18 - Collective action.
Section 59A-54-19 - Rates; standard risk rate.