New Mexico Administrative Code
Title 13 - INSURANCE
Chapter 10 - HEALTH INSURANCE
Part 30 - PHARMACY BENEFITS MANAGERS
Section 13.10.30.18 - COMPLIANCE REPORTING BY PBM
Universal Citation: 13 NM Admin Code 13.10.30.18
Current through Register Vol. 35, No. 18, September 24, 2024
PBMs shall submit the following information to determine compliance with New Mexico law according to the schedule provided by the superintendent:
A. Grievance and MAC appeal data. The PBM shall file a log of grievance and MAC appeal data using a form specified by the superintendent.
B. Pharmacy and therapeutics ("P&T") committee data. The PBM shall submit the following information for any P&T Committee:
(1)
names of committee members and conflict disclosure statements;
(2) dates and meeting minutes of the P&T
committee from the prior plan year; and
(3) statement of the P&T committee's
duties responsibilities, and goals.
C. Confidentiality of P&T committee data. P&T committee minutes provided to the superintendent shall be deemed confidential.
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