{"data":{"id":"us-nd/n.d.-cent.-code-19-02.1-16.6","jurisdiction":"us-nd","citation":"N.D. Cent. Code § 19-02.1-16.6","heading":"Clinician-administered drugs","body":"1.As used in this section:\na.\"Clinician-administered drug\" means an outpatient prescription drug other than a:\n(1)Vaccine that cannot be reasonably self-administered by the patient to whom the drug is prescribed;\n(2)Vaccine that typically is administered:\n(a)By a health care provider authorized under the laws of this state to administer the drug, including when acting under a physician's delegation and supervision; and\n(b)In a physician's office, hospital outpatient infusion center, pharmacy, or other clinical setting; or\n(3)Specialty drug.\nb.\"Pharmacy benefits manager\" has the same meaning as in section 19-03.6-01.\nc.\"Specialty drug\" has the same meaning as in section 19-02.1-16.2.\nd.\"Third-party payer\" has the same meaning as in section 19-03.6-01.\n2.A pharmacy benefits manager, third-party payer, or the agent of a pharmacy benefits manager or third-party payer may not:\na.Require a patient, as a condition of payment or reimbursement, to purchase pharmacist services, including prescription drugs, exclusively through a mail- order pharmacy or a pharmacy benefits manager affiliate, or a combination of both.\nb.Increase patient costs if the patient chooses to not use a mail-order pharmacy or a pharmacy benefits manager affiliate, but instead uses another participating provider.\nc.Interfere with the patient's right to obtain a clinician-administered drug from the patient's provider of choice.\nd.Limit or exclude availability of a clinician-administered drug if not dispensed by a mail-order pharmacy or pharmacy benefits manager affiliate, if the drug would otherwise be covered for patients.\ne.Condition, deny, restrict, or refuse to authorize or approve, or reduce payment to a participating provider for a clinician-administered drug if all criteria for medical necessity are met, because the participating provider did not obtain clinician- administered drugs from a mail-order pharmacy or pharmacy benefits manager affiliate.\nf.By contract, written policy, or written procedure, require that a pharmacy designated by the pharmacy benefits manager or third-party payer dispense a medication directly to a patient with the expectation or intention that the patient will transport the medication to a health care setting for administration by a participating provider.\ng.By contract, written policy, or written procedure, require that a pharmacy designated by the pharmacy benefits manager or third-party payer dispense a medication directly to a health care setting for a participating provider to administer to a patient.\nh.Require the use of a home infusion pharmacy to dispense clinician-administered drugs to a patient in the home of the patient.","path":["Title 19 Foods, Drugs, Oils, And Compounds","Chapter 19-02.1 North Dakota Food, Drug, And Cosmetic Act"],"source_url":"https://ndlegis.gov/cencode/t19c02-1.pdf","current_through":"2026-07-31T11:12:02","vintage":"","retrieved_at":"2026-09-02T21:04:14Z","sha256":"cacd3ac306fa4832542248edb15daf03a345bc002d81a64852b121bde77640d7","source_id":"us-nd","stale":true,"prev":"us-nd/n.d.-cent.-code-19-02.1-16.5","next":"us-nd/n.d.-cent.-code-19-02.1-17"},"notice":"GroundRules: Original legal text. Not legal advice."}