Starko, Inc. v. New Mexico Human Servs. Dep’t

In consolidated appeals, the issue this case presented to the New Mexico Supreme Court was whether pharmacists who dispense prescription drugs to Medicaid recipients must be paid under the formula set forth in NMSA 1978, Section 27-2-16(B) (1984). Section 27-2-16(B) was enacted when New Mexico only operated under a fee-for-services model. The Legislature created a new, alternative managed care system in 1994 in an effort to rein in costs of medical public assistance. The district court and our Court of Appeals held that Section 27-2-16(B) applied in both the fee-for-services context and in managed care settings. Upon review, however, the Supreme Court reversed, holding that Section 27-2-16(B) applied only in the fee-for-services context, which requires HSD to directly reimburse providers. View "Starko, Inc. v. New Mexico Human Servs. Dep't" on Justia Law