North Dakota legislation · 69th Legislative Assembly
North Dakota HB1216: AN ACT to create and enact a new section to chapter 26.1-36 of the North Dakota Century Code, relating to out-of-pocket expenses for prescription drugs; to amend and reenact section 26.1-36.6-03 of the North Dakota Century Code, relating to self-insurance health care plans; to provide for application; and to provide an effective date.
Status: Signed into law, May 2, 2025
Relating to out‑of‑pocket expenses for prescription drugs; to amend and reenact section 26.1‑36.6‑03 of the North Dakota Century Code, relating to self‑insurance health care plans; to provide for application; and to provide an effective date.
What the bill says
An act to create and enact a new section to chapter 26.1-36 of the North Dakota Century Code, relating to out-of-pocket expenses for prescription drugs; to amend and reenact section 26.1-36.6-03 of the North Dakota Century Code, relating to self-insurance health care plans; to provide for application; and to provide an effective date.
From the enrolled text, April 28, 2025:
AN ACT to create and enact a new section to chapter 26.1-36 of the North Dakota Century Code, relating to out-of-pocket expenses for prescription drugs; to amend and reenact section 26.1-36.6-03 of the North Dakota Century Code, relating to self-insurance health care plans; to provide for application; and to provide an effective date. SECTION 1. A new section to chapter 26.1-36 of the North Dakota Century Code is created and enacted as follows: Out - of - pocket expenses - Prescription drugs . 1. As used in this section: a. "Cost-sharing" means any coinsurance, copayment, or deductible under a health benefit plan. b. "Enrollee" means an individual entitled to prescription drug coverage under a health benefit plan. c. "Health benefit plan" has the same meaning as provided under section 26.1 - 36.3 - 01 . d. "Prescription drug" means a drug for which a prescription is or (2) With a generic equivalent, if the enrollee has obtained access to the drug through prior authorization, a step therapy protocol, or the heath care insurer's expectations and appeals process. 2. To the extent permitted by federal law and regulation, an insurer may not deliver, issue, execute, or renew a health benefit plan providing prescription drug coverage unless when calculating an enrollee's overall contribution to any ou t - o f - pocket …