This information applies to Medicaid members who have Blue Cross Community CentennialSM prescription drug benefits. Prime Therapeutics is the Pharmacy Benefit Manager (PBM) that provides drug benefits through Blue Cross and Blue Shield of New Mexico (BCBSNM).
- Medicaid Drug List — includes information about generics, preauthorization, specialty pharmacy, step therapy, OTC products, dispensing limits; also lists drugs by therapeutic categories.
- Medicaid Drug List Limitations, Exclusions, and Preauthorization Criteria – Pharmacy Benefits
- Medical Review Drugs and Criteria – Medical Benefits
- Drug Prior Authorization Request Form
- PrimeMail New Prescription Fax Order Form
- Specialty Pharmacy Fax Form
- Synagis Prior Authorization Form
Physicians can access, complete, and submit prior authorization and step therapy request forms electronically from the CoverMyMeds® website .
Specialty Pharmacy Program
Refer to Pharmacy Services in the Blue Cross Community Centennial section of the Blues Provider Reference Manual for a description of the Specialty Pharmacy Program, preauthorization requirements, and additional specialty services.
Services are funded in part under contract with the State of New Mexico.
Blue Cross and Blue Shield of New Mexico refers to HCSC Insurance Services Company (HISC), which is a wholly owned subsidiary of Health Care Service Corporation (HCSC), a Mutual Legal Reserve Company. Both HISC and HCSC are Independent Licensees of the Blue Cross and Blue Shield Association.