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Prescription drugs; prohibited formulary changes; notice requirements-N.M. Stat. Ann. § 59A-22-49.4

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Beginning on January 1, 2014, health insurance plans that cover prescription drugs under a cost-sharing method cannot change their coverage of prescription drugs more than once in a 120-day period. The specific coverage changes that are prohibited are listed in the statute. When an insurer does make changes to the coverage of prescription drugs, the insurer must provide written notice to all affected insured individuals 60 days in advance. If a drug is deemed unsafe by the Food and Drug Administration or is removed from the market, the insurance plan may remove the drug from its formulary without notice to affected insured individuals. Each insurance plan must provide insured individuals with information explaining the prescription drug benefits.


Current as of June 2015