25.0748.01000
Sixty-ninth
Legislative Assembly
of North Dakota
Introduced by
Representatives Nelson, Mitskog, O'Brien
A BILL for an Act to create and enact a new section to chapter 50-24.1 of the North Dakota
Century Code, relating to medical assistance prescription drug benefits for antiobesity
medication.
BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
SECTION 1. A new section to chapter 50-24.1 of the North Dakota Century Code is created
and enacted as follows:
Medical assistance benefits - Prescription drug coverage - Antiobesity medication.
1.Medical assistance coverage, including Medicaid expansion coverage, must include
comprehensive coverage for the treatment of obesity, which includes coverage for
intensive behavioral therapy, bariatric surgery, and antiobesity medication approved by
the United States food and drug administration.
2.The coverage criteria for antiobesity medication may not be more restrictive than the
United States food and drug administration approved indications.
3.The coverage provided under this section may not be different or separate from
coverage provided for any other illness, condition, or disorder for purposes of
determining deductibles, lifetime dollar limits, a benefit year maximum for deductibles,
and copayment and coinsurance factors.
4.This section may not be construed to preclude the undertaking of utilization
management to determine the medical necessity for treatment of obesity, provided all
appropriate medical necessity determinations are made in the same manner as those
determinations are made for the treatment of any other illness, condition, or disorder
covered by medical assistance benefits.
5.The department shall provide notice to an enrollee regarding the coverage required by
this section. The notice must be:
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24 Sixty-ninth
Legislative Assembly
a.In writing;
b.Prominently positioned in any literature or correspondence; and
c.Provided to an enrollee when annual information is made available to an
enrollee, or in another mailing to an enrollee, but no later than December 31,
2025.
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