Mail-order & Community Pharmacy Access
Upon enactment, HB132 will impact existing provisions within the Health Care Purchasing Act, the New Mexico Insurance Code, and the laws governing health maintenance organizations and pharmacy benefit managers. By implementing these changes, it seeks to level the playing field for community pharmacies, enabling them to compete more effectively with mail-order services. This change is particularly significant given the rise of e-pharmacies, which have become more prevalent in recent years, but have sometimes resulted in unequal treatment of local pharmacies while affecting the availability of local services.
House Bill 132 aims to enhance access and equity in healthcare by establishing regulations that require parity between participating mail-order pharmacies and community pharmacies. This bill mandates that health insurance plans allow any licensed pharmacy in New Mexico to participate in the network for pharmacy benefits, provided that the pharmacy agrees to the terms set forth by the health insurance provider. Moreover, it ensures that enrollees have the option to procure their medications from either type of pharmacy without facing discriminatory costs associated with copayments or coinsurance.
The bill is not without contention, as stakeholders have expressed differing opinions on its implications for healthcare dynamics. Supporters posit that HB132 will ultimately enhance patient choices and foster a more competitive environment among pharmacies, which may lead to better pricing and accessibility for consumers. Conversely, detractors worry about the potential financial impact on insurance providers and the possible strain on pharmacy benefit managers who now must accommodate a wider network of service providers, potentially driving up costs in the healthcare system.