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North Dakota Century Code Title 26.1. Insurance § 26.1-36-12.2. Freedom of choice for pharmacy services

Current as of January 01, 2024 | Updated by Findlaw Staff

1. No third-party payer, including a health care insurer as defined in section 26.1-47-01, providing pharmacy services and prescription drugs to any beneficiary may:

a. Prevent a beneficiary from selecting the pharmacy or pharmacist of the beneficiary's choice to provide pharmaceutical goods and services, provided that pharmacist or pharmacy is licensed in this state;

b. Impose upon any beneficiary selecting a participating or contracting provider a copayment, fee, or other condition not equally imposed upon all beneficiaries in the plan selecting a participating or contracting provider; or

c. Deny any pharmacy or pharmacist the right to participate as a preferred provider under chapter 26.1-47 or as a contracting provider for any policy or plan, provided the pharmacist or pharmacy is licensed in this state, and accepts the terms of the third-party payer's contract.

2. Notwithstanding the provisions of subsection 1, the department of health and human services may exclude, from participation in the medical assistance program administered under chapter 50-24.1 and title XIX of the Social Security Act [Pub. L. 89-97; 79 Stat. 343; 42 U.S.C. 1396 et seq.], as amended, any provider of pharmacy services who does not agree to comply with state and federal requirements governing the program, or who, after so agreeing, fails to comply with those requirements.

3. Any provision in a health insurance policy in this state which violates the provisions in subsection 1 is void.

4. Any person who violates this section is guilty of a class A misdemeanor and each violation is a separate offense. The commissioner may levy an administrative penalty not to exceed ten thousand dollars for a violation of this section.

5. The insurance commissioner shall enforce the provisions of this section.

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Cite this article: FindLaw.com - North Dakota Century Code Title 26.1. Insurance § 26.1-36-12.2. Freedom of choice for pharmacy services - last updated January 01, 2024 | https://codes.findlaw.com/nd/title-26-1-insurance/nd-cent-code-sect-26-1-36-12-2/

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