N.D. Cent. Code § 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.