New Mexico § 27-2-12.21 - Medical assistance; pharmacy benefits; prescription synchronization

§ 27-2-12.21. Medical assistance; pharmacy benefits; prescription synchronization

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.