New Mexico § 59A-22B-4 Duties of office; prescribing penalties

New Mexico Statutes

§ 59A-22B-4 — Duties of office; prescribing penalties

New Mexico § 59A-22B-4

Ch. 59AInsurance Code

Art. 22BPrior Authorization

This text of New Mexico § 59A-22B-4 (Duties of office; prescribing penalties) is published on Counsel Stack Legal Research, covering New Mexico primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

N.M. Stat. Ann. § 59A-22B-4 (2026).

Text

A.The office shall standardize and streamline the prior authorization process across all health insurers.

B.On or before September 1, 2019, the office shall, in collaboration with health insurers and health care providers, promulgate a uniform prior authorization form for medical care, pharmaceutical benefits or related benefits to be used by every health insurer and health care provider after January 1, 2020; provided that the uniform prior authorization form shall conform to the requirements established for medicare and medicaid medical and pharmacy prior authorization requests.

C.The office shall maintain a log of complaints against health insurers for failure to comply with the Prior Authorization Act. After two warnings issued by the superintendent of insurance, the office may levy

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A. The office shall standardize and streamline the prior authorization process across all health insurers. B. On or before September 1, 2019, the office shall, in collaboration with health insurers and health care providers, promulgate a uniform prior authorization form for medical care, pharmaceutical benefits or related benefits to be used by every health insurer and health care provider after January 1, 2020; provided that the uniform prior authorization form shall conform to the requirements established for medicare and medicaid medical and pharmacy prior authorization requests. C. The office shall maintain a log of complaints against health insurers for failure to comply with the Prior Authorization Act. After two warnings issued by the superintendent of insurance, the office may levy a fine of not more than five thousand dollars ($5,000) on a health insurer that fails to comply with the provisions of the Prior Authorization Act. D. By September 1, 2019, and each September 1 thereafter, the office shall provide an annual written report to the governor and the legislature to include, at a minimum: (1) prior authorization data for each health insurer individually and for health insurers collectively; (2) the number and nature of complaints against individual health insurers for failure to follow the Prior Authorization Act; and (3) actions taken by the office, including the imposition of fines, against individual health insurers to enforce compliance with the Prior Authorization Act. E. The annual written report shall be posted on the office's website.