The bill amends section 50-24.6-04 of the North Dakota Century Code to enhance the prior authorization program for medically necessary medications. It establishes a certification program to verify the medical necessity of medications prescribed in regimens containing five or more concurrent prescriptions for specific classes of drugs, including antipsychotics and antidepressants. The department is required to develop this certification program, which mandates annual certification by prescribers to confirm that the medications are medically necessary. If a prescriber fails to certify a medication, the department may deny payment until certification is provided.

Additionally, the bill modifies existing provisions regarding prior authorization by removing age-specific restrictions and clarifying that the department cannot prior authorize substantially all drugs in certain medication classes, with exceptions for specific circumstances. It also introduces new definitions, such as "line extension drug," and outlines the department's authority to negotiate additional rebates from drug manufacturers. Overall, the bill aims to streamline the process for obtaining necessary medications while ensuring that prescribers affirm the medical necessity of complex regimens.

Statutes affected:
PREFILED: 50-24.6-04
Adopted by the House Human Services Committee: 50-24.6-04
Enrollment: 50-24.6-04
INTRODUCED: 50-24.6-04