NM SB20

Extends Prior Authorization Act requirements to pharmacy benefits managers (PBMs) contracted with entities under the Health Care Purchasing Act, requiring them to use uniform authorization forms and maintain electronic portal systems

Prohibits prior authorization for FDA-approved medications treating autoimmune disorders, cancer, rare diseases, serious mental illness, or substance use disorders when a specialist determines medical necessity (exception: when biosimilar or generic versions are available)

Defines "serious mental illness" to include major depression, schizophrenia, schizoaffective disorder, bipolar disorder, obsessive-compulsive disorder, panic disorder, PTSD, and borderline personality disorder

Limits re-authorization for chronic maintenance drugs to once every three years after initial approval, unless fraud occurs, FDA takes regulatory action, or a generic/biosimilar becomes available

Applies to individual and group health policies entered into on or after January 1, 2027, covering health insurers, HMOs, nonprofit health care plans, and entities under the Health Care Purchasing Act