This bill amends section 50-24.6-04 of the North Dakota Century Code to enhance the prior authorization program for drug coverage under medical assistance. The department is tasked with developing a program that aligns with federal requirements, ensuring that authorization for prescribed drugs is granted when certain conditions are met, such as the ineffectiveness of non-authorized drugs or potential adverse reactions. The bill also mandates that the department provide relevant medical and clinical criteria, cost information, and utilization data to the drug use review board for their evaluation of drugs requiring prior authorization.

Significant changes include the removal of age-specific restrictions on prior authorization for certain medication classes, which previously differentiated between individuals under and over eighteen years of age. The bill introduces new language stating that restrictions do not apply if a drug manufacturer excludes the department from rebate offers due to prior authorization requirements. Additionally, the definition of "line extension drug" is clarified, and the term "substantially all" is refined to specify that it refers to all drugs in the outlined medication classes, with certain exceptions. The department is also empowered to negotiate additional rebates from drug manufacturers to enhance the medical assistance program's funding.

Statutes affected:
INTRODUCED: 50-24.6-04
PREFILED: 50-24.6-04