New Mexico Statutes Chapter 59A. Insurance Code § 59A-47-47. Prescription drug prior authorization protocols

A. After January 1, 2014, a health care plan shall accept the uniform prior authorization form developed pursuant to Sections 2 and 3 of this 2013 act as sufficient to request prior authorization for prescription drug benefits.

B. No later than twenty-four months after the adoption of national standards for electronic prior authorization, a health insurer shall exchange prior authorization requests with providers who have e-prescribing capability.

C. If a health care plan fails to use or accept the uniform prior authorization form or fails to respond within three business days upon receipt of a uniform prior authorization form, the prior authorization request shall be deemed to have been granted.

D. As used in this section, “health care plan” means a nonprofit corporation authorized by the superintendent to enter into contracts with subscribers and to make health care expense payments but does not include: