Title 19 — Foods, Drugs, Oils, and Compounds
40 chapters · 234 sections in this title.
N.D.C.C. § 19-03.6-01 Definitions
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For the purposes of this chapter: 1. "Entity" means a managed care company, an insurance company, a third-party payer, a pharmacy benefits manager, or any other organization that represents an insurance company, a third-party payer, or a pharmacy benefits manager. 2. "Insurance c…
N.D.C.C. § 19-03.6-02 Pharmacy benefits manager audit - Rules
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1. An entity conducting an audit of a pharmacy shall: a. If conducting an onsite audit, give the pharmacy a written notice at least fourteen business days before conducting an initial audit. b. If the audit involves clinical or professional judgment, ensure the audit is conducted…
N.D.C.C. § 19-03.6-04 Applicability
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1. This chapter applies to claims adjudicated after July 31, 2011. 2. This chapter does not apply to any audit, review, or investigation that is initiated based upon alleged fraud, willful misrepresentation, or abuse, including: a. Insurance fraud as defined in chapter 26.1-02.1.…
N.D.C.C. § 19-03.6-05 Penalty
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Any person violating this chapter is guilty of a class B misdemeanor.