New Mexico SB20 standardizes prior authorization processes for health insurers and pharmacy benefits managers, exempts certain drugs from prior.
New Mexico SB20 establishes a standardized prior authorization process for health insurers and pharmacy benefits managers. It mandates the use of a uniform prior authorization form and an electronic portal for submitting and auto-adjudicating requests. The bill exempts certain medications, such as those for autoimmune disorders and cancer, from prior authorization if prescribed based on a medical necessity determination. It also prohibits step therapy requirements for these medications.
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- Critical Issues
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