N.M. Admin. Code § 8.324.4.13 - COVERAGE REQUIREMENTS
A.
Legal requirements: All drug items must be assigned a national
drug code by the respective manufacturer, repackager or labeler. A prescription
must meet all federal and state laws, regulations and rules. A pharmacy
provider and a prescriber must fulfill all the requirements of federal and
state laws relating to his or her practice and ethics.
B.
Rebate requirements: MAD pays
only for the drugs of pharmaceutical manufacturers that have entered into and
have in effect a rebate agreement with the federal department of health and
human services. This limitation does not apply to dispensing a single-source or
innovator multiple-source drug if MAD has determined that the availability of
the drug is essential to the health of a MAP eligible recipient.
C.
Prescribing: A prescriber
must be enrolled as a MAD provider in order to prescribe drug items for a MAP
eligible recipient. A provider who has been terminated or suspended by MAD or
is not enrolled as a provider must notify his or her MAP eligible recipients
that he or she cannot prescribe drug items for them.
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