New Mexico

New Mexico has no DPC laws at present and we are not aware of any planned at this time. At least one DPC practice appears to be operating within the state. Be sure to review the New Mexico (Chapter 59A Insurance Code - Justia citation) insurance laws when planning your DPC practice, note that New Mexico makes it very difficult to conduct any in-office dispensing.

Medication Dispensing Issues: Section 16.10.16.9 DISTRIBUTION OF MEDICATIONS

Section A makes it clear that a PA generally may not dispense medications.

Section B contains some confusing language:

"Distribution of a medication shall be restricted to medications repackaged by a licensed pharmacist or a pharmaceutical manufacturer or re-packager. Physician assistants may request, receive and sign for professional sample medications and may distribute sample medications to patients. A log must be kept of distributed medications in accordance with board of pharmacy regulations. Samples requested/received would be appropriate to the scope of the supervising physician's practice and would be consistent with board of pharmacy regulations."

My interpretation: You may dispense medications from wholesalers to your own patients as long as you carefully log them and make no attempt to repackage (count) them in any way.

Questions may be direct to the New Mexico Medical Board.

Medicaid

New Mexico is a managed care state. The state should have a Medicaid managed care provider manual establishing its own rules, but I was not able to locate this document. Molina is a selected managed care provider and they do have a Medicaid Provider Manual that is publicly available. Under page 25 the “Balanced Billing” section the manual states “Providers contracted with Molina cannot bill the Member for any covered benefits. The Provider is responsible for verifying eligibility and obtaining approval for those services that require prior authorization. Providers may not charge Members fees for covered services beyond copayments.”