New Mexico § 13-7-17 - Pharmacy benefits; prescription synchronization

§ 13-7-17. Pharmacy benefits; prescription synchronization

A. Group health coverage, including any form of self-insurance, offered, issued or

renewed under the Health Care Purchasing Act that offers a prescription drug benefit

shall allow an enrollee to fill or refill a prescription for less than a thirty-day

supply of the prescription drug, and apply a prorated daily copayment or coinsurance

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 patient 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 patient's

prescription drug fills. B. Group health coverage, including any form of self-insurance, offered, issued or

renewed under the Health Care Purchasing Act that offers a prescription drug benefit

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 enrollee pursuant

to Subsection A of this section established among the group health plan, the prescribing

practitioner and a pharmacist. The group health plan 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 group health plan 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 enrollee may pay for prescription synchronization

services.