Bill > HB174

This bill requires health insurance plans covered under the Health Care Purchasing Act to reimburse community-based pharmacies more comprehensively for prescription drugs. Specifically, the bill mandates that these insurance plans pay pharmacies the full ingredient cost of a prescription drug at least equal to the national average drug acquisition cost (or wholesale acquisition cost if that data is unavailable), plus a professional dispensing fee that is no less than the fee paid by Medicaid's fee-for-service program. The bill carefully defines a "community-based pharmacy provider" as a publicly accessible pharmacy located in or near the state border, which is not government-owned, hospital-owned, part of a corporate chain, a mail-order pharmacy, or an extension of a medical practice. These new reimbursement requirements are designed to support local, independent pharmacies by ensuring they receive fair compensation for prescription drugs, with the provisions set to take effect on January 1, 2026. The bill aims to provide more financial stability for smaller, local pharmacies by standardizing and potentially increasing their reimbursement rates from health insurance plans.

Budget and Finance, Health and Social Services

https://www.nmlegis.gov/Legislation/Legislation?chamber=H&legtype=B&legno=174&year=25