PHARMACY REIMBURSEMENT FOR CERTAIN PLANS

HB 174 requires health insurance plans under New Mexico's Health Care Purchasing Act to reimburse community-based pharmacies for the full cost of prescription drugs (using either the national average drug acquisition cost or wholesale cost) plus a professional dispensing fee. It directly affects local pharmacies that serve the public, are not hospital-owned or part of out-of-state chains, and meet specific location criteria - excluding government, hospital, or mail-order pharmacies. The bill mandates that the dispensing fee must match the rate paid to pharmacies in New Mexico's Medicaid program. This law takes effect January 1, 2026, and aims to ensure fair reimbursement for community pharmacies providing prescription services.