N.D. Cent. Code § 19-02.1-16.2

Current through 2023 Legislative Sessions

Section 19-02.1-16.2 - Specialty pharmacy services and patient access to pharmaceuticals - Pharmacy benefits managers Penalty

1. As used in this section:

a. "Pharmacy benefits manager" has the same meaning as in section 19-03.6-01.

b. "Plan sponsor" has the same meaning as in section 19-03.6-01.

c. "Specialty drug" means a prescription drug that:

(1) Is not available for order or purchase by a retail community pharmacy and long-term care pharmacy, regardless of whether the drug is meant to be self-administered; and

(2) Requires special storage and has distribution or inventory limitations not available at a retail community pharmacy or long-term care pharmacy.

d. "Third-party payer" has the same meaning as in section 19-03.6-01.

2. If requested by a plan sponsor contracted payer, a pharmacy benefits manager or third-party payer that has an ownership interest, either directly or through an affiliate or subsidiary, in a pharmacy shall disclose to the plan sponsor contracted payer any difference between the amount paid to a pharmacy and the amount charged to the plan sponsor contracted payer.

3. A pharmacy benefits manager or a pharmacy benefits manager's affiliates or subsidiaries may not own or have an ownership interest in a patient assistance program and a mail order specialty pharmacy, unless the pharmacy benefits manager, affiliate, or subsidiary agrees to not participate in a transaction that benefits the pharmacy benefits manager, affiliate, or subsidiary instead of another person owed a fiduciary duty.

4. A pharmacy benefits manager or third-party payer may not require pharmacy accreditation standards or recertification requirements to participate in a network which are inconsistent with, more stringent than, or in addition to the federal and state requirements for licensure as a pharmacy in this state.

5. A licensed pharmacy or pharmacist may dispense any and all drugs allowed under that license.

6. A pharmacy benefits manager or other third-party payer that violates this section is guilty of a class B misdemeanor for each violation occurrence.

N.D.C.C. § 19-02.1-16.2

Added by S.L. 2017, ch. 162 (SB 2301),§ 1, eff. 8/1/2017.