All Roll Calls
Yes: 183 • No: 2
North DakotaSB 20762025 Regular SessionSenateWALLET
AN ACT to amend and reenact section 50-24.6-04 of the North Dakota Century Code, relating to prior authorization and certification of medically necessary medication.
Sponsored By: Senate Human Services
Became Law
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 3 benefits, 0 costs, 2 mixed.
Clear rules for Medicaid drug pre-approvals
North Dakota Medicaid sets a clear prior authorization program for prescription drugs. The Department must approve a drug if another covered option did not work, caused harm, or the drug is a medically accepted use. Approval does not apply if a therapeutically equivalent drug is available without pre-approval. The Department also helps providers find treatment when no compendium-supported drug exists.
Fewer pre-approvals for key Medicaid meds
The state may not put most drugs in key classes on the prior authorization list for adults and minors. These classes include antipsychotics, antidepressants, anticonvulsants, HIV drugs, cancer drugs, and transplant immunosuppressants. Limited exceptions apply, like reasonable quantity limits, brand/generic post‑rebate cost comparisons, and some line‑extension drugs. A manufacturer’s rebate or value deal changes can also affect these limits for adults.
More rebates to lower Medicaid drug costs
The state can seek extra rebates from drug makers and join a multistate rebate pool. If it negotiates outside that pool, other makers can match those rebates. These tools help cut net drug costs for Medicaid and can support access.
Extra checks for youth on 5+ meds
If a child under 18 has five or more concurrent prescriptions in certain classes, prior authorization is required. After the prescriber consults a board‑certified child and adolescent psychiatrist approved by the state, the Department allows care over the limits. For people under 22 with five or more prescriptions in those classes, each prescriber must certify yearly that each drug is medically necessary. The Department can deny payment for a drug until the prescriber certifies.
How ND Medicaid runs drug reviews
When the state adds a drug to prior authorization, it shares clinical, cost, and use data with the Drug Use Review Board. The Department writes rules with the Board and must let prescribers submit documents without harming patient care. The Board can form expert panels, and the Department can hire contractors to help run the program. These steps can improve decisions but may also expand reviews for some drugs.
Sponsors & Cosponsors
Sponsor
Senate Human Services
Affiliation unavailable
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
Senate vote • 4/9/2025
Second reading, passed, yeas 46 nays 0
Yes: 46 • No: 0
House vote • 3/28/2025
Second reading, passed as amended, yeas 92 nays 0
Yes: 92 • No: 0
Senate vote • 1/15/2025
Second reading, passed, yeas 45 nays 2
Yes: 45 • No: 2
Actions Timeline
Filed with Secretary Of State 04/16
4/18/2025HouseSigned by Governor 04/16
4/17/2025SenateSent to Governor
4/15/2025SenateSigned by President
4/14/2025SenateSigned by Speaker
4/14/2025HouseSecond reading, passed, yeas 46 nays 0
4/9/2025SenateConcurred
4/9/2025SenateReturned to Senate (12)
3/31/2025SenateSecond reading, passed as amended, yeas 92 nays 0
3/28/2025HouseAmendment adopted, placed on calendar
3/26/2025HouseReported back amended, do pass, amendment placed on calendar 12 0 1
3/25/2025HouseCommittee Hearing 11:00
3/11/2025HouseIntroduced, first reading, referred Human Services Committee
2/13/2025HouseReceived from Senate
1/16/2025HouseSecond reading, passed, yeas 45 nays 2
1/15/2025SenateReported back, do pass, place on calendar 6 0 0
1/14/2025SenateCommittee Hearing 09:30
1/14/2025SenateIntroduced, first reading, referred Human Services Committee
1/7/2025Senate
Bill Text
Adopted by the House Human Services Committee
Enrollment
INTRODUCED
SENATE BILL NO. 2076 with House Amendments
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