N.M. Stat. § 13-7-18. Prescription drug coverage; step therapy protocols; clinical review criteria; exceptions: Health Care Purchasing Act – New Mexico

Status: Enacted
Year Enacted: 2018
File: Download

A. Group health coverage, including any form of self-insurance, offered, issued or renewed under the Health Care Purchasing Act that provides coverage for prescription drugs for which any step therapy protocols are required shall establish clinical review criteria for those step therapy protocols. The clinical review criteria shall be based on clinical practice guidelines that:

Key Issues: PHARMACEUTICALS Tiered Network or Narrow Network PRICE AND QUALITY TRANSPARENCY Quality Measure Cost-Sharing or Out-of-Pocket Costs HEALTHCARE COSTS Drug Formulary HEALTHCARE MARKETS Drug Pricing Provider Network

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N.M. Stat. § 13-7-18. Prescription drug coverage; step therapy protocols; clinical review criteria; exceptions: Health Care Purchasing Act – New Mexico

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