A. A person shall not operate as a pharmacy benefits manager unless licensed by the superintendent in accordance with the Pharmacy Benefits Manager Regulation Act and applicable federal and state laws. A licensee shall renew the licensee's pharmacy benefits manager license annually.

B. An initial application and a renewal application for licensure as a pharmacy benefits manager shall be made on a form and in a manner provided for by the superintendent, but at a minimum shall require:

(1) the identity of the pharmacy benefits manager;

(2) the name and business address of the contact person for the pharmacy benefits manager;

(3) where applicable, the federal employer identification number for the pharmacy benefits manager; and

(4) any other information specified in rules promulgated by the superintendent.

C. The superintendent shall enforce and promulgate rules to implement the provisions of the Pharmacy Benefits Manager Regulation Act and may suspend or revoke a license issued to a pharmacy benefits manager or deny an application for a license or renewal of a license if:

(1) the pharmacy benefits manager is operating in contravention of its application;

(2) the pharmacy benefits manager has failed to continuously meet or comply with the requirements for issuance or maintenance of a license; or

(3) the pharmacy benefits manager has failed to comply with applicable state or federal laws or rules.

D. If the license of a pharmacy benefits manager is revoked, the manager shall proceed, immediately following the effective date of the order of revocation, to conclude its affairs, notify each pharmacy in its network and conduct no further pharmacy benefits management services in the state, except as may be essential to the orderly conclusion of its affairs. The superintendent may permit further operation of the pharmacy benefits manager if the superintendent finds it to be in the best interest of patients.

E. A person whose pharmacy benefits manager license has been denied, suspended or revoked may seek review of the denial, suspension or revocation pursuant to the provisions of Chapter 59A, Article 4 NMSA 1978.

F. Nothing in the Pharmacy Benefits Manager Regulation Act shall be construed to authorize a pharmacy benefits manager to transact the business of insurance.

History: Laws 2014, ch. 14, § 3; 2019, ch. 269, § 2.

The 2019 amendment, effective July 1, 2019, provided for renewal of pharmacy benefits manager licensure; in the section heading, deleted "License" and added "Licensure; initial application; annual renewal required; revocation"; in Subsection A, added "A licensee shall renew the licensee's pharmacy benefits manager license annually."; in Subsection B, in the introductory clause, after "An", added "initial", after "application", added "and a renewal application", and after "pharmacy benefits manager", added "shall be made on a form and in a manner provided for by the superintendent, but at a minimum", and added Paragraph B(4); in Subsection C, deleted Paragraph C(4); in Subsection D, after "its affairs", added "notify each pharmacy in its network", after "no further", deleted "business" and added "pharmacy benefits management services in the state"; and added Subsection F.