North Dakota 2025-2026 Regular Session

North Dakota Senate Bill SB2248 Compare Versions

Only one version of the bill is available at this time.

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1	1	25.0547.02000
2	2	Sixty-ninth
3	3	Legislative Assembly
4	4	of North Dakota
5	5	Introduced by
6	6	Senators Barta, Dever, Lee
7	7	Representatives D. Ruby, Weisz, Louser
8	8	A BILL for an Act to amend and reenact section 19-02.1-16.3 of the North Dakota Century
9	9	Code, relating to step therapy protocols; to provide for a report to the legislative assembly; to
10	10	provide for application; and to provide an expiration date.
11	11	BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
12	12	SECTION 1. AMENDMENT. Section 19-02.1-16.3 of the North Dakota Century Code is
13	13	amended and reenacted as follows:
14	14	19-02.1-16.3. Pharmacy benefits managers - Step therapy protocols - Limitations.
15	15	1.As used in this section:
16	16	a."Associated condition" means a symptom or side effect associated with
17	17	metastatic cancer or its treatment and which, in the judgment of the health care
18	18	practitioner, further jeopardizes the health of an individual if left untreated.
19	19	b."Metastatic cancer" means cancer that has spread from the primary or original
20	20	site to lymph nodes, nearby tissues, or other parts of the body.
21	21	b.c."Pharmacy benefits manager" has the same meaning as in section 19-03.6-01.
22	22	c.d."Step therapy protocol" means a protocol requiring an individual use a drug, or
23	23	sequence of drugs, other than the prescription drug, or sequence of prescription
24	24	drugs, the individual's health care provider recommends for the individual's
25	25	treatment, before the pharmacy benefits manager or health plan allows coverage
26	26	for the recommended prescription drug, or sequence of prescription drugs.
27	27	2.A pharmacy benefits manager or a health plan may not require a step therapy protocol
28	28	for coverage of a recommended prescription drug, or sequence of prescription drugs,
29	29	approved by the United States food and drug administration if:
30	30	Page No. 1 25.0547.02000
31	31	SENATE BILL NO. 2248
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54	54	22 Sixty-ninth
55	55	Legislative Assembly
56	56	a.The recommended prescription drug, or sequence of prescription drugs, is
57	57	prescribed to treat the individual's diagnosis of metastatic cancer or an
58	58	associated condition; and
59	59	b.The use of the recommended prescription drug, or sequence of prescription
60	60	drugs, is consistent with the United States food and drug administration-approved
61	61	indications or is supported by peer-reviewed medical literature.
62	62	3.This section does not require coverage of a nonformulary prescription drug.
63	63	SECTION 2. PUBLIC EMPLOYEES RETIREMENT SYSTEM - STEP THERAPY
64	64	PROTOCOLS FOR ASSOCIATED CONDITIONS OF METASTATIC CANCER - REPORT TO
65	65	LEGISLATIVE ASSEMBLY. Pursuant to section 54-03-28, the public employees retirement
66	66	system shall prepare and submit for introduction a bill to the seventieth legislative assembly to
67	67	repeal the expiration date for this Act and to extend step therapy protocols for associated
68	68	conditions of metastatic cancer to all group and individual health insurance policies. The public
69	69	employees retirement system shall append a report to the bill regarding the effect of the step
70	70	therapy protocols for associated conditions of metastatic cancer on the system's health
71	71	insurance programs, information on the utilization and costs relating to the coverage, and a
72	72	recommendation regarding whether the coverage should be continued.
73	73	SECTION 3. APPLICATION. This Act applies to health insurance benefits coverage
74	74	provided by the uniform group insurance program under chapter 54-52.1 which begins after
75	75	June 30, 2025, and which does not extend past June 30, 2027.
76	76	SECTION 4. EXPIRATION DATE. This Act is effective through June 30, 2027, and after that
77	77	date is ineffective.
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