2011 New Mexico Statutes
Chapter 13: Public Purchases and Property
Article 7: Health Care Purchasing, 13-7-1 through 13-7-12
Section 13-7-12: Coverage for orally administered anticancer medications; limits on patient costs.
13-7-12. Coverage for orally administered anticancer medications; limits on patient costs.
A. Group health coverage, including any form of self-insurance, offered, issued or renewed under the Health Care Purchasing Act that provides coverage for cancer treatment shall provide coverage for a prescribed, orally administered anticancer medication that is used to kill or slow the growth of cancerous cells on a basis no less favorable than intravenously administered or injected cancer medications that are covered as medical benefits by the plan.
B. A group health plan shall not increase patient cost-sharing for anticancer medications in order to achieve compliance with the provisions of this section.
C. Coverage of orally administered anticancer medication shall not be subject to any prior authorization, dollar limit, copayment, deductible or coinsurance provision that does not apply to intravenously administered or injected anticancer medication used to kill or slow the growth of cancerous cells.
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