{"data":{"id":"us-nm/59a-61-2","jurisdiction":"us-nm","citation":"59A-61-2","heading":"Definitions.","body":"As used in the Pharmacy Benefits Manager Regulation Act:\nA. \"maximum allowable cost\" means the maximum amount that a pharmacy benefits manager will reimburse a pharmacy for the cost of a generic drug;\nB. \"maximum allowable cost list\" means a searchable, electronic and internet-based listing of drugs used by a pharmacy benefits manager setting the maximum allowable cost on which reimbursement to a pharmacy or pharmacist is made;\nC. \"obsolete\" means a product that is listed in national drug pricing compendia but is no longer available to be dispensed based on the expiration date of the last lot manufactured;\nD. \"pharmacist\" means an individual licensed as a pharmacist by the board of pharmacy;\nE. \"pharmacy\" means a licensed place of business where drugs are compounded or dispensed and pharmacist services are provided;\nF. \"pharmacy benefits management\" means a service provided to or conducted by a health plan as defined in Section 59A-16-21.1 NMSA 1978 or health insurer that involves:\n(1) prescription drug claim administration;\n(2) pharmacy network management;\n(3) negotiation and administration of prescription drug discounts, rebates and other benefits;\n(4) design, administration or management of prescription drug benefits;\n(5) formulary management;\n(6) payment of claims to pharmacies for dispensing prescription drugs;\n(7) negotiation or administration of contracts relating to pharmacy operations or prescription benefits; or\n(8) any other service determined by the superintendent as specified by rule to be a pharmacy benefits management activity;\nG. \"pharmacy benefits manager\" means an entity that provides pharmacy benefits management services;\nH. \"pharmacy benefits manager affiliate\" means a pharmacy or pharmacist that directly or indirectly, through one or more intermediaries, owns or controls, is owned or controlled by or is under common ownership or control with a pharmacy benefits manager;\nI. \"pharmacy services administrative organization\" means an entity that contracts with a pharmacy or pharmacist to act as the pharmacy or pharmacist's agent with respect to matters involving a pharmacy benefits manager or third-party payor, including negotiating, executing or administering contracts with the pharmacy benefits manager or third-party payor; and\nJ. \"superintendent\" means the superintendent of insurance.","path":["Chapter 59A - Insurance Code","ARTICLE 61 Pharmacy Benefits Manager Regulation"],"source_url":"https://nmonesource.com/nmos/nmsa-unanno/en/item/18562/index.do","current_through":"2026-07-01","vintage":"","retrieved_at":"2026-09-03T15:02:20Z","sha256":"e9402c6ff99c092ee39843b62d677feeae106c63ee408c09af3a5955492ba0c4","source_id":"us-nm","stale":false,"prev":"us-nm/59a-61-1","next":"us-nm/59a-61-3"},"notice":"GroundRules: Original legal text. Not legal advice."}