23.1064.03000
Sixty-eighth
Legislative Assembly SENATE BILL NO. 2378
of North Dakota
Introduced by
Senators Meyer, Klein
Representatives Kasper, Lefor, Mock, Rohr
1 A BILL for an Act to create and enact a new section to chapter 19-02.1 of the North Dakota
2 Century Code, relating to clinician-administered drugs.
3 BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
4 SECTION 1. A new section to chapter 19-02.1 of the North Dakota Century Code is created
5 and enacted as follows:
6 Clinician-administered drugs.
7 1. As used in this section:
8 a. "Clinician-administered drug" means an outpatient prescription drug other than a:
9 (1) Vaccine that cannot be reasonably self-administered by the patient to whom
10 the drug is prescribed;
11 (2) Vaccine that typically is administered:
12 (a) By a health care provider authorized under the laws of this state to
13 administer the drug, including when acting under a physician's
14 delegation and supervision; and
15 (b) In a physician's office, hospital outpatient infusion center, pharmacy,
16 or other clinical setting; or
17 (3) Specialty drug.
18 b. "Pharmacy benefits manager" has the same meaning as in section 19-03.6-01.
19 c. "Specialty drug" has the same meaning as in section 19-02.1-16.2
20 d. "Third-party payer" has the same meaning as in section 19-03.6-01.
21 2. A pharmacy benefits manager, third-party payer, or the agent of a pharmacy benefits
22 manager or third-party payer may not:
23 a. Require a patient, as a condition of payment or reimbursement, to purchase
24 pharmacist services, including prescription drugs, exclusively through a mail-
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Legislative Assembly
1 order pharmacy or a pharmacy benefits manager affiliate, or a combination of
2 both.
3 b. Increase patient costs if the patient chooses to not use a mail-order pharmacy or
4 a pharmacy benefits manager affiliate, but instead uses another participating
5 provider.
6 c. Interfere with the patient's right to obtain a clinician-administered drug from the
7 patient's provider of choice.
8 d. Limit or exclude availability of a clinician-administered drug if not dispensed by a
9 mail-order pharmacy or pharmacy benefits manager affiliate, if the drug would
10 otherwise be covered for patients.
11 e. Condition, deny, restrict, or refuse to authorize or approve, or reduce payment to
12 a participating provider for a clinician-administered drug if all criteria for medical
13 necessity are met, because the participating provider did not obtain clinician-
14 administered drugs from a mail-order pharmacy or pharmacy benefits manager
15 affiliate.
16 f. By contract, written policy, or written procedure, require that a pharmacy
17 designated by the pharmacy benefits manager or third-party payer dispense a
18 medication directly to a patient with the expectation or intention that the patient
19 will transport the medication to a health care setting for administration by a
20 participating provider.
21 g. By contract, written policy, or written procedure, require that a pharmacy
22 designated by the pharmacy benefits manager or third-party payer dispense a
23 medication directly to a health care setting for a participating provider to
24 administer to a patient.
25 h. Require the use of a home infusion pharmacy to dispense clinician-administered
26 drugs to a patient in the home of the patient.
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