New Mexico Administrative Code
Title 13 - INSURANCE
Chapter 10 - HEALTH INSURANCE
Part 31 - PRIOR AUTHORIZATION
Section 13.10.31.2 - SCOPE
Current through Register Vol. 35, No. 18, September 24, 2024
These rules apply to every:
A. health insurer as defined in Subsection H of Section 59A-22B-2 NMSA 1978;
B. multiple employer welfare arrangement; and
C. Medicaid managed care organization, that requires prior authorization as a condition to payment for a medical service, pharmaceutical, or medical supply benefit. The subject entities are referred to collectively herein as "carriers" and individually as a "carrier." The requirements of these rules supersede any conflicting provision of any rule previously adopted by the superintendent, and are superseded by any conflicting provision of federal or state law applicable to a Medicaid managed care organization.
