SENATE BILL 39, ADD CLASSES TO PRIOR AUTHORIZATION DRUGS

This is an update to Bulletin No. 2025-005, dated August 1, 2025, references to “calendar days”
have been changed to “business days” on page 3 and page 4.

Senate Bill 39 (SB39) was signed into law by Governor Michelle Lujan Grisham on April 7, 2025, and
became effective July 1, 2025. SB39 amends the Prior Authorization Act, NMSA 1978, Sections
59A-22B-2, 59A-22B-5, and 59A-22B-8 to include the following:

• removes prior-authorization and/or step therapy requirements for Food & Drug Administration (FDA) approved drugs used off-label for the treatment of rare diseases or conditions;
• requires coverage for these medications to be made pursuant to a medical necessity determination made by a health care professional from the same or similar practice specialty that typically manages the medical condition, procedure, or treatment under review;
• sets time frames for medical necessity determinations; and
• amended the definition for “prior authorization” and added new definitions to include “off label” and “rare disease or condition” in NMSA 1978, Section 59A-22B-2.

For complete content please see PDF below.

SENATE BILL 39, ADD CLASSES TO PRIOR AUTHORIZATION DRUGS (PDF)