This bill seeks to amend and enact various provisions concerning pharmacy benefits managers (PBMs) in North Dakota, primarily focusing on the establishment of a licensing requirement and an enforcement fund. It mandates that PBMs obtain a license from the commissioner before operating in the state, with an initial application fee capped at $10,000 and a similar fee for annual renewals. The bill also requires PBMs to demonstrate financial responsibility of $1 million and introduces regulations to enhance transparency in their contractual practices, including opt-in contracts with a minimum response time of 30 days and a 90-day notice for pharmacies wishing to opt-out. The commissioner is granted enforcement powers, including the ability to issue subpoenas, while the attorney general retains the authority to investigate and prosecute violations.

Additionally, the legislation establishes administrative penalties for PBMs that violate the law, which can include fines up to $10,000 per violation, license suspension or revocation, and civil penalties of up to $50,000 for subsequent violations. It creates a Pharmacy Benefit Manager Enforcement Fund, funded by fees from wholesaler licenses, to support the enforcement of these new regulations. The bill also includes provisions for serving legal documents to licensees and allocates $1.2 million for the insurance commissioner to enforce the new rules and analyze their impact on health insurance premiums and drug prices. The bill is set to take effect on January 1, 2026, with certain provisions expiring on June 30, 2029.

Statutes affected:
INTRODUCED: 26.1-27.1-01, 26.1-27.1-02, 26.1-27.1-04, 26.1-27.1-06, 26.1-27.1-07
Adopted by the House Industry, Business and Labor Committee: 26.1-27.1-01, 26.1-27.1-02, 26.1-27.1-04, 26.1-27.1-06, 26.1-27.1-07
FIRST ENGROSSMENT: 26.1-27.1-01, 26.1-27.1-02, 26.1-27.1-04, 26.1-27.1-06, 26.1-27.1-07
Adopted by the Senate Industry and Business Committee: 26.1-01-07, 26.1-01-07.1, 26.1-27.1-01, 26.1-27.1-02, 26.1-27.1-04, 26.1-27.1-06, 26.1-27.1-07
Prepared by the Legislative Council staff for Senator Sickler: 26.1-01-07, 26.1-27.1-01, 26.1-27.1-02, 26.1-27.1-04, 26.1-27.1-06, 26.1-27.1-07
Enrollment: 26.1-01-07, 26.1-27.1-01, 26.1-27.1-02, 26.1-27.1-04, 26.1-27.1-06, 26.1-27.1-07