Signed by Governor Michelle Lujan Grisham

Vote Smart's Synopsis:

Vote to pass a bill that authorizes cost-sharing contributions for prescription drugs.

Highlights:

• Authorizes cost-sharing contributions for the following, at no charge to individuals beginning January 1, 2024, including (Sec. 1):

• Prescription drugs or pharmacy services obtained at a non-affilaiated pharmacy; or

• Adminstration of prescription drugs at different infusion provided that an insurer may communicate with an insured regarding lower-cost sites of service.

• Prohibits insurers, beginning January 1, 2024 from requiring an insured make mayment at a point of sale for a covered prescription drug in an amount greater that of the following, including (Sec. 1):

• Applicable cost-sharing amount for the prescription drug;

• Amount an insured would pay for the prescription drug if the insured purchased the prescription drug without using a health benefits plan or any other souce of prescription drug benefits or discounts;

• Total amount the pharmacy will be reimbursed for the prescription drug from the insurer, including the cost-sharing amount paid by an insurer; or

• Value of the rebate from the manufacturer provided to the insurer or its pharmacy benefits manager for the prescribed drug.

• Specifies that beginning January 1, 2024 any rebate amount shall be counted toward the insured’s out-of-state pocket prescription drug costs (Sec. 1).

• Defines “cost sharing” as the following, including (Sec. 1):

• Copayments;

• Coinsurance;

• Deductible;

• Out-of-pocket maximum amount;

• Other financial obligation, other than premium or share of a premium; or

• Combination thereof.

• Specifies that the provisions of this bill shall take effect upon passage and approval by the governor (Sec. 7).

Full Bill Text