50-24.6 Medical Assistance Drug Use Review and Authorization
Download pdf
CHAPTER 50-24.6MEDICAL ASSISTANCE DRUG USE REVIEW AND AUTHORIZATION50-24.6-01. Definitions. As used in this chapter, unless the context otherwise requires:1."Board" means the drug use review board.2."Compendium" means the American hospital formulary service drug information,<br>United States pharmacopeia-drug information, the DRUGDEX information system,<br>American medical association drug evaluations, or nonproprietary peer-reviewed<br>medical literature.3."Department" means the department of human services.4."Drug use review" means a program as described in 42 U.S.C. 1396r-8(g)(2).5."Drug use review criteria" means standards approved by the board for use in<br>determining whether use of a drug is likely to be medically appropriate, to be<br>medically necessary, and not result in adverse medical outcomes.6."Prior authorization" means a process requiring the prescriber or the dispenser to<br>verify with the department or the department's contractor that proposed medical use<br>of a particular drug for a medical assistance program recipient meets predetermined<br>criteria for coverage by the medical assistance program.50-24.6-02. Drug use review board.1.The board is established within the department for the implementation of a drug use<br>review program.2.The board consists of seventeen members.The pharmacy administrator of thedepartment and the medical consultant to the department are ex officio nonvoting<br>board members who shall provide administrative services to the board. A majority of<br>the appointed members must be physicians and pharmacists participating in the<br>medical assistance program. Four or more of the appointed members must have<br>experience with a drug use review process or have participated in programs in which<br>prior authorization is used. The appointed members of the board must be:a.Four physicians licensed in this state and actively engaged in the practice of<br>medicine, one of whom is a psychiatrist, appointed by the North Dakota<br>medical association;b.Two physicians licensed in this state and actively engaged in the practice of<br>medicine, appointed by the executive director of the department;c.Four pharmacists licensed in this state and actively engaged in the practice of<br>pharmacy, appointed by the North Dakota pharmaceutical association;d.Two pharmacists licensed in this state and actively engaged in the practice of<br>pharmacy, appointed by the executive director of the department;e.One individual who represents consumer interests, appointed by the governor;f.One pharmacist or physician representing the brand pharmaceutical industry<br>appointed by the pharmaceutical research and manufacturers of America; andg.One pharmacist or physician representing the generic pharmaceutical industry<br>appointed by the generic pharmaceutical association.Page No. 13.Appointed board members shall serve staggered three-year terms. An appointed<br>member may be reappointed for a period not to exceed three 3-year terms.Avacancy on the board must be filled for the balance of the unexpired term from the<br>appropriate board category as provided under subsection 2. The executive director<br>of the department may replace an appointed member of the board who fails to<br>attend three consecutive meetings of the board without advance excuse or who fails<br>to perform the duties expected of a board member. The pharmaceutical industry<br>representatives are nonvoting board members.4.Voting board members shall select a chairman and a vice chairman on an annual<br>basis from the board's voting membership.5.The board shall meet in person at least once every three months and may meet at<br>other times by teleconference or electronically at the discretion of the chairman. A<br>board member is entitled to receive from the department per diem compensation<br>and reimbursement of expenses as determined by the department, except that no<br>compensation under this section may be paid to any board member who receives<br>compensation or salary as a state employee or official.50-24.6-03. Duties of the board. The board shall:1.Cooperate with the department to create and implement a prospective and<br>retrospective drug use review program for outpatient prescription drugs under the<br>medical assistance program. This drug use review program must be based on a<br>compendium and drug use review criteria and must comply with 42 U.S.C.<br>1396r-8(g)(3).2.Advise and make recommendations regarding any rule proposed for adoption by the<br>department to implement the provisions of state and federal law related to drug use<br>review.3.Receive and consider information regarding the drug use review process which is<br>provided by the department and by interested parties, including prescribers who<br>treat significant numbers of patients under the department's medical assistance<br>program.4.Review and recommend to the department any drugs to be included on prior<br>authorization status.5.Review no less than once each year the status of the list of drugs that have been<br>placed on prior authorization.6.Review and approve the prior authorization program process used by the<br>department, including the process to accommodate the provision of a drug benefit in<br>an emergency situation.7.Propose remedial strategies to improve the quality of care and to promote effective<br>use of medical assistance program funds or recipient expenditures.50-24.6-04. Prior authorization program.1.The department shall develop and implement a prior authorization program that<br>meets the requirements of 42 U.S.C. 1396r-8(d) to determine coverage of drug<br>products when a medical assistance recipient's health care provider prescribes a<br>drug that is identified as requiring prior authorization. Authorization must be granted<br>for provision of the drug if:Page No. 2a.The drug not requiring prior authorization has not been effective, or with<br>reasonable certainty is not expected to be effective, in treating the recipient's<br>condition;b.The drug not requiring prior authorization causes or is reasonably expected to<br>cause adverse or harmful reactions to the health of the recipient; orc.The drug is prescribed for a medically accepted use supported by a<br>compendium or by approved product labeling unless there is a therapeutically<br>equivalent drug that is available without prior authorization.2.For any drug placed on the prior authorization program, the department shall provide<br>medical and clinical criteria, cost information, and utilization data to the drug use<br>review board for review and consideration. The board may consider department<br>data and information from other sources to make a decision about placement of the<br>drug on prior authorization.3.Except for quantity limits that may be no less than the pharmaceutical<br>manufacturer's package insert, or brand name drugs with a generic equivalent drug<br>for which the cost to the state postrebate is less than the brand name drugs, in the<br>aggregate, the department may not prior authorize the following medication classes:a.Antipsychotics;b.Antidepressants;c.Anticonvulsants;d.Antiretrovirals, for the treatment of human immunodeficiency virus;e.Antineoplastic agents, for the treatment of cancer; andf.Stimulant medication used for the treatment of attention deficit disorder and<br>attention deficit hyperactivity disorder.4.The department may use contractors to collect and analyze the documentation<br>required under this section and to facilitate the prior authorization program.5.The department shall consult with the board in the course of adopting rules to<br>implement the prior authorization program. The rules must:a.Establishpoliciesandproceduresnecessarytoimplementthepriorauthorization program.b.Develop a process that allows prescribers to furnish documentation required to<br>obtain approval for a drug without interfering with patient care activities.c.Allow the board to establish panels of physicians and pharmacists which<br>provide expert guidance and recommendations to the board in considering<br>specific drugs or therapeutic classes of drugs to be included in the prior<br>authorization program.50-24.6-05. Public notice - Applicability.1.The department shall provide thirty days' notice of all meetings of the board. The<br>notice requirement is met if the department provides notice of the meeting on the<br>department's web site and provides, by written or electronic means, individual notice<br>to each person that has requested such notice. If the meeting agenda includes<br>board consideration of a change to the prior authorization program, the departmentPage No. 3shall include in the notice a list of the affected drugs, and upon request the board<br>shall provide background information. Any interested party may attend a meeting of<br>the board and provide information or recommendations related to the inclusion of a<br>drug in a prior authorization program.2.The department shall post on the department's web site:a.The most current and applicable list of drugs requiring prior authorization,<br>together with any limits on coverage of these drugs.b.In downloadable format, forms necessary to complete prior authorization<br>requests.c.Decisions regarding changes to the prior authorization program list.Thedepartment shall allow a period of no less than thirty days for public comment<br>following posting on the web site.d.Meeting notice.3.The department may not discontinue the provision of prescription drug benefits<br>being provided to medical assistance recipients before April 14, 2003, based solely<br>on the subsequent placement of the drug on the prior authorization program.50-24.6-06. Grievances. Expired under S.L. 2003, ch. 430,</div></article><aside class="right-sidebar"><div class="related-sidebar"><h3><span class="emoji">⚖️</span> State Laws</h3><ul class="state-laws-list"><li><a href="https://state-laws.laws.com/state-of-alabama">The State Laws of <!-- -->Alabama</a></li><li><a href="https://state-laws.laws.com/state-of-alaska">The State Laws of <!-- -->Alaska</a></li><li><a href="https://state-laws.laws.com/state-of-arizona">The State Laws of <!-- -->Arizona</a></li><li><a href="https://state-laws.laws.com/state-of-arkansas">The State Laws of <!-- -->Arkansas</a></li><li><a href="https://state-laws.laws.com/state-of-california">The State Laws of <!-- -->California</a></li><li><a href="https://state-laws.laws.com/state-of-colorado">The State Laws of <!-- -->Colorado</a></li><li><a href="https://state-laws.laws.com/state-of-connecticut">The State Laws of <!-- -->Connecticut</a></li><li><a href="https://state-laws.laws.com/state-of-delaware">The State Laws of <!-- -->Delaware</a></li><li><a href="https://state-laws.laws.com/state-of-florida">The State Laws of <!-- -->Florida</a></li><li><a href="https://state-laws.laws.com/state-of-georgia">The State Laws of <!-- -->Georgia</a></li><li><a href="https://state-laws.laws.com/state-of-hawaii">The State Laws of <!-- -->Hawaii</a></li><li><a href="https://state-laws.laws.com/state-of-idaho">The State Laws of <!-- -->Idaho</a></li><li><a href="https://state-laws.laws.com/state-of-illinois">The State Laws of <!-- -->Illinois</a></li><li><a href="https://state-laws.laws.com/state-of-indiana">The State Laws of <!-- -->Indiana</a></li><li><a href="https://state-laws.laws.com/state-of-iowa">The State Laws of <!-- -->Iowa</a></li><li><a href="https://state-laws.laws.com/state-of-kansas">The State Laws of <!-- -->Kansas</a></li><li><a href="https://state-laws.laws.com/state-of-kentucky">The State Laws of <!-- -->Kentucky</a></li><li><a href="https://state-laws.laws.com/state-of-louisiana">The State Laws of <!-- -->Louisiana</a></li><li><a href="https://state-laws.laws.com/state-of-maine">The State Laws of <!-- -->Maine</a></li><li><a href="https://state-laws.laws.com/state-of-maryland">The State Laws of <!-- -->Maryland</a></li><li><a href="https://state-laws.laws.com/state-of-massachusetts">The State Laws of <!-- -->Massachusetts</a></li><li><a href="https://state-laws.laws.com/state-of-michigan">The State Laws of <!-- -->Michigan</a></li><li><a href="https://state-laws.laws.com/state-of-minnesota">The State Laws of <!-- -->Minnesota</a></li><li><a href="https://state-laws.laws.com/state-of-mississippi">The State Laws of <!-- -->Mississippi</a></li><li><a href="https://state-laws.laws.com/state-of-missouri">The State Laws of <!-- -->Missouri</a></li><li><a href="https://state-laws.laws.com/state-of-montana">The State Laws of <!-- -->Montana</a></li><li><a href="https://state-laws.laws.com/state-of-nebraska">The State Laws of <!-- -->Nebraska</a></li><li><a href="https://state-laws.laws.com/state-of-nevada">The State Laws of <!-- -->Nevada</a></li><li><a href="https://state-laws.laws.com/state-of-new-hampshire">The State Laws of <!-- -->New Hampshire</a></li><li><a href="https://state-laws.laws.com/state-of-new-jersey">The State Laws of <!-- -->New Jersey</a></li><li><a href="https://state-laws.laws.com/state-of-new-mexico">The State Laws of <!-- -->New Mexico</a></li><li><a href="https://state-laws.laws.com/state-of-new-york">The State Laws of <!-- -->New York</a></li><li><a href="https://state-laws.laws.com/state-of-north-carolina">The State Laws of <!-- -->North Carolina</a></li><li><a href="https://state-laws.laws.com/state-of-north-dakota">The State Laws of <!-- -->North Dakota</a></li><li><a href="https://state-laws.laws.com/state-of-ohio">The State Laws of <!-- -->Ohio</a></li><li><a href="https://state-laws.laws.com/state-of-oklahoma">The State Laws of <!-- -->Oklahoma</a></li><li><a href="https://state-laws.laws.com/state-of-oregon">The State Laws of <!-- -->Oregon</a></li><li><a href="https://state-laws.laws.com/state-of-pennsylvania">The State Laws of <!-- -->Pennsylvania</a></li><li><a href="https://state-laws.laws.com/state-of-rhode-island">The State Laws of <!-- -->Rhode Island</a></li><li><a href="https://state-laws.laws.com/state-of-south-carolina">The State Laws of <!-- -->South Carolina</a></li><li><a href="https://state-laws.laws.com/state-of-south-dakota">The State Laws of <!-- -->South Dakota</a></li><li><a href="https://state-laws.laws.com/state-of-tennessee">The State Laws of <!-- -->Tennessee</a></li><li><a href="https://state-laws.laws.com/state-of-texas">The State Laws of <!-- -->Texas</a></li><li><a href="https://state-laws.laws.com/state-of-utah">The State Laws of <!-- -->Utah</a></li><li><a href="https://state-laws.laws.com/state-of-vermont">The State Laws of <!-- -->Vermont</a></li><li><a href="https://state-laws.laws.com/state-of-virginia">The State Laws of <!-- -->Virginia</a></li><li><a href="https://state-laws.laws.com/state-of-washington">The State Laws of <!-- -->Washington</a></li><li><a href="https://state-laws.laws.com/state-of-west-virginia">The State Laws of <!-- -->West Virginia</a></li><li><a href="https://state-laws.laws.com/state-of-wisconsin">The State Laws of <!-- -->Wisconsin</a></li><li><a href="https://state-laws.laws.com/state-of-wyoming">The State Laws of <!-- -->Wyoming</a></li></ul></div></aside></div></section><!--$--><!--/$--><footer class="footer"></footer><script src="/_next/static/chunks/2a2449c32e1f321b.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR" id="_R_" async=""></script><script>(self.__next_f=self.__next_f||[]).push([0])</script><script>self.__next_f.push([1,"1:\"$Sreact.fragment\"\n2:I[39756,[\"/_next/static/chunks/ff1a16fafef87110.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR\",\"/_next/static/chunks/d2be314c3ece3fbe.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR\"],\"default\"]\n3:I[37457,[\"/_next/static/chunks/ff1a16fafef87110.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR\",\"/_next/static/chunks/d2be314c3ece3fbe.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR\"],\"default\"]\n4:I[79520,[\"/_next/static/chunks/744355e03808d4c7.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR\"],\"\"]\n6:I[97367,[\"/_next/static/chunks/ff1a16fafef87110.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR\",\"/_next/static/chunks/d2be314c3ece3fbe.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR\"],\"OutletBoundary\"]\n7:\"$Sreact.suspense\"\n9:I[97367,[\"/_next/static/chunks/ff1a16fafef87110.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR\",\"/_next/static/chunks/d2be314c3ece3fbe.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR\"],\"ViewportBoundary\"]\nb:I[97367,[\"/_next/static/chunks/ff1a16fafef87110.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR\",\"/_next/static/chunks/d2be314c3ece3fbe.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR\"],\"MetadataBoundary\"]\nd:I[68027,[\"/_next/static/chunks/ff1a16fafef87110.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR\",\"/_next/static/chunks/d2be314c3ece3fbe.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR\"],\"default\"]\n:HL[\"https://fonts.googleapis.com/css2?family=SF+Pro+Display:wght@300;400;500;600;700\u0026display=swap\",\"style\"]\n:HL[\"/includes/statutes-pages.css?v=2\",\"style\"]\n"])</script><script>self.__next_f.push([1,"0:{\"P\":null,\"b\":\"QO7shand-zMNSFf865LMc\",\"c\":[\"\",\"north-dakota\",\"t-50\",\"t-50-c-246\",\"\"],\"q\":\"\",\"i\":false,\"f\":[[[\"\",{\"children\":[[\"state\",\"north-dakota\",\"d\"],{\"children\":[[\"slug\",\"t-50/t-50-c-246\",\"c\"],{\"children\":[\"__PAGE__\",{}]}]}]},\"$undefined\",\"$undefined\",true],[[\"$\",\"$1\",\"c\",{\"children\":[[[\"$\",\"script\",\"script-0\",{\"src\":\"/_next/static/chunks/744355e03808d4c7.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR\",\"async\":true,\"nonce\":\"$undefined\"}]],[\"$\",\"html\",null,{\"lang\":\"en\",\"children\":[[\"$\",\"head\",null,{\"children\":[[\"$\",\"meta\",null,{\"charSet\":\"UTF-8\"}],[\"$\",\"meta\",null,{\"name\":\"viewport\",\"content\":\"width=device-width, initial-scale=1.0\"}],[\"$\",\"link\",null,{\"rel\":\"preconnect\",\"href\":\"https://fonts.googleapis.com\"}],[\"$\",\"link\",null,{\"rel\":\"preconnect\",\"href\":\"https://fonts.gstatic.com\",\"crossOrigin\":\"anonymous\"}],[\"$\",\"link\",null,{\"href\":\"https://fonts.googleapis.com/css2?family=SF+Pro+Display:wght@300;400;500;600;700\u0026display=swap\",\"rel\":\"stylesheet\"}],[\"$\",\"link\",null,{\"rel\":\"stylesheet\",\"href\":\"/includes/statutes-pages.css?v=2\"}]]}],[\"$\",\"body\",null,{\"children\":[[\"$\",\"header\",null,{\"className\":\"header\"}],[\"$\",\"$L2\",null,{\"parallelRouterKey\":\"children\",\"error\":\"$undefined\",\"errorStyles\":\"$undefined\",\"errorScripts\":\"$undefined\",\"template\":[\"$\",\"$L3\",null,{}],\"templateStyles\":\"$undefined\",\"templateScripts\":\"$undefined\",\"notFound\":[[[\"$\",\"title\",null,{\"children\":\"404: This page could not be found.\"}],[\"$\",\"div\",null,{\"style\":{\"fontFamily\":\"system-ui,\\\"Segoe UI\\\",Roboto,Helvetica,Arial,sans-serif,\\\"Apple Color Emoji\\\",\\\"Segoe UI Emoji\\\"\",\"height\":\"100vh\",\"textAlign\":\"center\",\"display\":\"flex\",\"flexDirection\":\"column\",\"alignItems\":\"center\",\"justifyContent\":\"center\"},\"children\":[\"$\",\"div\",null,{\"children\":[[\"$\",\"style\",null,{\"dangerouslySetInnerHTML\":{\"__html\":\"body{color:#000;background:#fff;margin:0}.next-error-h1{border-right:1px solid rgba(0,0,0,.3)}@media (prefers-color-scheme:dark){body{color:#fff;background:#000}.next-error-h1{border-right:1px solid rgba(255,255,255,.3)}}\"}}],[\"$\",\"h1\",null,{\"className\":\"next-error-h1\",\"style\":{\"display\":\"inline-block\",\"margin\":\"0 20px 0 0\",\"padding\":\"0 23px 0 0\",\"fontSize\":24,\"fontWeight\":500,\"verticalAlign\":\"top\",\"lineHeight\":\"49px\"},\"children\":404}],[\"$\",\"div\",null,{\"style\":{\"display\":\"inline-block\"},\"children\":[\"$\",\"h2\",null,{\"style\":{\"fontSize\":14,\"fontWeight\":400,\"lineHeight\":\"49px\",\"margin\":0},\"children\":\"This page could not be found.\"}]}]]}]}]],[]],\"forbidden\":\"$undefined\",\"unauthorized\":\"$undefined\"}],[\"$\",\"footer\",null,{\"className\":\"footer\"}],[\"$\",\"$L4\",null,{\"src\":\"/includes/statutes-inject.js?v=1\",\"strategy\":\"afterInteractive\"}]]}]]}]]}],{\"children\":[[\"$\",\"$1\",\"c\",{\"children\":[null,[\"$\",\"$L2\",null,{\"parallelRouterKey\":\"children\",\"error\":\"$undefined\",\"errorStyles\":\"$undefined\",\"errorScripts\":\"$undefined\",\"template\":[\"$\",\"$L3\",null,{}],\"templateStyles\":\"$undefined\",\"templateScripts\":\"$undefined\",\"notFound\":\"$undefined\",\"forbidden\":\"$undefined\",\"unauthorized\":\"$undefined\"}]]}],{\"children\":[[\"$\",\"$1\",\"c\",{\"children\":[null,[\"$\",\"$L2\",null,{\"parallelRouterKey\":\"children\",\"error\":\"$undefined\",\"errorStyles\":\"$undefined\",\"errorScripts\":\"$undefined\",\"template\":[\"$\",\"$L3\",null,{}],\"templateStyles\":\"$undefined\",\"templateScripts\":\"$undefined\",\"notFound\":\"$undefined\",\"forbidden\":\"$undefined\",\"unauthorized\":\"$undefined\"}]]}],{\"children\":[[\"$\",\"$1\",\"c\",{\"children\":[\"$L5\",[[\"$\",\"script\",\"script-0\",{\"src\":\"/_next/static/chunks/7c92e96509cd355e.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR\",\"async\":true,\"nonce\":\"$undefined\"}]],[\"$\",\"$L6\",null,{\"children\":[\"$\",\"$7\",null,{\"name\":\"Next.MetadataOutlet\",\"children\":\"$@8\"}]}]]}],{},null,false,false]},null,false,false]},null,false,false]},null,false,false],[\"$\",\"$1\",\"h\",{\"children\":[null,[\"$\",\"$L9\",null,{\"children\":\"$La\"}],[\"$\",\"div\",null,{\"hidden\":true,\"children\":[\"$\",\"$Lb\",null,{\"children\":[\"$\",\"$7\",null,{\"name\":\"Next.Metadata\",\"children\":\"$Lc\"}]}]}],null]}],false]],\"m\":\"$undefined\",\"G\":[\"$d\",[]],\"S\":false}\n"])</script><script>self.__next_f.push([1,"a:[[\"$\",\"meta\",\"0\",{\"charSet\":\"utf-8\"}],[\"$\",\"meta\",\"1\",{\"name\":\"viewport\",\"content\":\"width=device-width, initial-scale=1\"}]]\n8:null\nc:[[\"$\",\"title\",\"0\",{\"children\":\"T-50-C-246 - North Dakota Statutes - LAWS.com\"}],[\"$\",\"meta\",\"1\",{\"name\":\"description\",\"content\":\"T-50-C-246 - North Dakota State Statutes and Laws\"}],[\"$\",\"link\",\"2\",{\"rel\":\"canonical\",\"href\":\"https://statutes.laws.com/north-dakota/t-50/t-50-c-246/\"}]]\n"])</script><script>self.__next_f.push([1,"e:I[22016,[\"/_next/static/chunks/744355e03808d4c7.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR\",\"/_next/static/chunks/7c92e96509cd355e.js?dpl=dpl_AQPhqj6aLt1ver5KqnebmCuHPZxR\"],\"\"]\n"])</script><script>self.__next_f.push([1,"5:[[\"$\",\"nav\",null,{\"className\":\"breadcrumb\",\"children\":[\"$\",\"ul\",null,{\"className\":\"breadcrumb-list\",\"children\":[[\"$\",\"li\",null,{\"children\":[\"$\",\"a\",null,{\"href\":\"https://laws.com/\",\"children\":\"LAWS\"}]}],[\"$\",\"li\",null,{\"className\":\"breadcrumb-separator\",\"children\":\"\u003e\"}],[\"$\",\"li\",null,{\"children\":[\"$\",\"a\",null,{\"href\":\"/\",\"children\":\"STATUTES\"}]}],[\"$\",\"li\",null,{\"className\":\"breadcrumb-separator\",\"children\":\"\u003e\"}],[\"$\",\"li\",null,{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/\",\"children\":\"NORTH DAKOTA\"}]}],[[\"$\",\"span\",\"0\",{\"children\":[[\"$\",\"li\",null,{\"className\":\"breadcrumb-separator\",\"children\":\"\u003e\"}],[\"$\",\"li\",null,{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-50/\",\"children\":\"T-50\"}]}]]}],[\"$\",\"span\",\"1\",{\"children\":[[\"$\",\"li\",null,{\"className\":\"breadcrumb-separator\",\"children\":\"\u003e\"}],[\"$\",\"li\",null,{\"children\":[\"$\",\"span\",null,{\"children\":\"T-50-C-246\"}]}]]}]]]}]}],[\"$\",\"section\",null,{\"className\":\"article-section\",\"children\":[\"$\",\"div\",null,{\"className\":\"article-grid\",\"children\":[[\"$\",\"aside\",null,{\"className\":\"sidebar-nav\",\"children\":[\"$\",\"div\",null,{\"className\":\"sidebar-card\",\"children\":[[\"$\",\"h3\",null,{\"children\":[[\"$\",\"span\",null,{\"className\":\"emoji\",\"children\":\"📚\"}],\" \",\"North Dakota\",\" Statutes\"]}],[\"$\",\"ul\",null,{\"className\":\"toc-list\",\"children\":[[\"$\",\"li\",\"859214\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-1/\",\"children\":\"Chapter 1 General Provisions\"}]}],[\"$\",\"li\",\"859232\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-2/\",\"children\":\"Chapter 2 Aeronautics\"}]}],[\"$\",\"li\",\"859252\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-3/\",\"children\":\"Chapter 3 Agency\"}]}],[\"$\",\"li\",\"859265\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-4/\",\"children\":\"Chapter 4 Agriculture\"}]}],[\"$\",\"li\",\"859448\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-5/\",\"children\":\"Chapter 5 Alcoholic Beverages\"}]}],[\"$\",\"li\",\"859458\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-6/\",\"children\":\"Chapter 6 Banks and Banking\"}]}],[\"$\",\"li\",\"859532\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/cct-7/\",\"children\":\"Chapter 7 Building and Loan Associations\"}]}],[\"$\",\"li\",\"859534\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-8/\",\"children\":\"Chapter 8 Carriage\"}]}],[\"$\",\"li\",\"859570\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-9/\",\"children\":\"Chapter 9 Contracts and Obligations\"}]}],[\"$\",\"li\",\"859609\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-10/\",\"children\":\"Chapter 10 Corporations\"}]}],[\"$\",\"li\",\"859704\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-11/\",\"children\":\"Chapter 11 Counties\"}]}],[\"$\",\"li\",\"859802\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-12/\",\"children\":\"Chapter 12 Corrections, Parole, and Probation\"}]}],[\"$\",\"li\",\"860058\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-13/\",\"children\":\"Chapter 13 Debtor and Creditor Relationship\"}]}],[\"$\",\"li\",\"860088\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-14/\",\"children\":\"Chapter 14 Domestic Relations and Persons\"}]}],[\"$\",\"li\",\"860181\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-15/\",\"children\":\"Chapter 15 Education\"}]}],[\"$\",\"li\",\"860479\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-16/\",\"children\":\"Chapter 16 Elections\"}]}],[\"$\",\"li\",\"860581\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-17/\",\"children\":\"Chapter 17 Energy\"}]}],[\"$\",\"li\",\"860600\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-18/\",\"children\":\"Chapter 18 Fires\"}]}],[\"$\",\"li\",\"860633\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-19/\",\"children\":\"Chapter 19 Foods, Drugs, Oils, and Compounds\"}]}],[\"$\",\"li\",\"860709\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/cct-20/\",\"children\":\"Chapter 20 Game, Fish, and Predators\"}]}],[\"$\",\"li\",\"860747\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-21/\",\"children\":\"Chapter 21 Governmental Finance\"}]}],[\"$\",\"li\",\"860779\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-22/\",\"children\":\"Chapter 22 Guaranty, Indemnity, and Suretyship\"}]}],[\"$\",\"li\",\"860800\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-23/\",\"children\":\"Chapter 23 Health and Safety\"}]}],[\"$\",\"li\",\"860968\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-24/\",\"children\":\"Chapter 24 Highways, Bridges, and Ferries\"}]}],[\"$\",\"li\",\"861007\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-25/\",\"children\":\"Chapter 25 Mental and Physical Illness or Disability\"}]}],[\"$\",\"li\",\"861058\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/cct-26/\",\"children\":\"Chapter 26 Insurance\"}]}],[\"$\",\"li\",\"861267\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-27/\",\"children\":\"Chapter 27 Judicial Branch of Government\"}]}],[\"$\",\"li\",\"861335\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-28/\",\"children\":\"Chapter 28 Judicial Procedure, Civil\"}]}],\"$Lf\",\"$L10\",\"$L11\",\"$L12\",\"$L13\",\"$L14\",\"$L15\",\"$L16\",\"$L17\",\"$L18\",\"$L19\",\"$L1a\",\"$L1b\",\"$L1c\",\"$L1d\",\"$L1e\",\"$L1f\",\"$L20\",\"$L21\",\"$L22\",\"$L23\",\"$L24\",\"$L25\",\"$L26\",\"$L27\",\"$L28\",\"$L29\",\"$L2a\",\"$L2b\",\"$L2c\",\"$L2d\",\"$L2e\",\"$L2f\",\"$L30\",\"$L31\",\"$L32\",\"$L33\",\"$L34\",\"$L35\",\"$L36\",\"$L37\",\"$L38\",\"$L39\",\"$L3a\",\"$L3b\"]}]]}]}],\"$L3c\",\"$L3d\"]}]}]]\n"])</script><script>self.__next_f.push([1,"f:[\"$\",\"li\",\"861417\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-29/\",\"children\":\"Chapter 29 Judicial Procedure, Criminal\"}]}]\n10:[\"$\",\"li\",\"861522\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-30/\",\"children\":\"Chapter 30 Judicial Procedure, Probate\"}]}]\n11:[\"$\",\"li\",\"861661\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-31/\",\"children\":\"Chapter 31 Judicial Proof\"}]}]\n12:[\"$\",\"li\",\"861694\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-32/\",\"children\":\"Chapter 32 Judicial Remedies\"}]}]\n13:[\"$\",\"li\",\"861823\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-33/\",\"children\":\"Chapter 33 County Justice Court\"}]}]\n14:[\"$\",\"li\",\"861847\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-34/\",\"children\":\"Chapter 34 Labor and Employment\"}]}]\n15:[\"$\",\"li\",\"861886\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-35/\",\"children\":\"Chapter 35 Liens\"}]}]\n16:[\"$\",\"li\",\"861967\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-36/\",\"children\":\"Chapter 36 Livestock\"}]}]\n17:[\"$\",\"li\",\"862032\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-37/\",\"children\":\"Chapter 37 Military\"}]}]\n18:[\"$\",\"li\",\"862098\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-38/\",\"children\":\"Chapter 38 Mining and Gas and Oil Production\"}]}]\n19:[\"$\",\"li\",\"862174\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-39/\",\"children\":\"Chapter 39 Motor Vehicles\"}]}]\n1a:[\"$\",\"li\",\"862279\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-40/\",\"children\":\"Chapter 40 Municipal Government\"}]}]\n1b:[\"$\",\"li\",\"859412\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-41/\",\"children\":\"Chapter 4.1 Agriculture\"}]}]\n1c:[\"$\",\"li\",\"862438\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-41/\",\"children\":\"Chapter 41 Uniform Commercial Code\"}]}]\n1d:[\"$\",\"li\",\"862465\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-42/\",\"children\":\"Chapter 42 Nuisances\"}]}]\n1e:[\"$\",\"li\",\"862485\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-43/\",\"children\":\"Chapter 43 Occupations and Professions\"}]}]\n1f:[\"$\",\"li\",\"862642\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-44/\",\"children\":\"Chapter 44 Offices and Officers\"}]}]\n20:[\"$\",\"li\",\"862667\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-45/\",\"children\":\"Chapter 45 Partnerships\"}]}]\n21:[\"$\",\"li\",\"862721\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-46/\",\"children\":\"Chapter 46 Printing Laws\"}]}]\n22:[\"$\",\"li\",\"862733\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-47/\",\"children\":\"Chapter 47 Property\"}]}]\n23:[\"$\",\"li\",\"862824\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-48/\",\"children\":\"Chapter 48 Public Buildings\"}]}]\n24:[\"$\",\"li\",\"862854\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-49/\",\"children\":\"Chapter 49 Public Utilities\"}]}]\n25:[\"$\",\"li\",\"862918\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-50/\",\"children\":\"Chapter 50 Public Welfare\"}]}]\n26:[\"$\",\"li\",\"863036\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-51/\",\"children\":\"Chapter 51 Sales and Exchanges\"}]}]\n27:[\"$\",\"li\",\"863101\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-52/\",\"children\":\"Chapter 52 Social Security\"}]}]\n28:[\"$\",\"li\",\"863135\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-53/\",\"children\":\"Chapter 53 Sports and Amusements\"}]}]\n29:[\"$\",\"li\",\"863182\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-54/\",\"children\":\"Chapter 54 State Government\"}]}]\n2a:[\"$\",\"li\",\"863420\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-55/\",\"children\":\"Chapter 55 State Historical Society and State Parks\"}]}]\n2b:[\"$\",\"li\",\"863439\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/cct-56/\",\"children\":\"Chapter 56 Succession and Wills\"}]}]\n2c:[\"$\",\"li\",\"863442\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-57/\",\"children\":\"Chapter 57 Taxation\"}]}]\n2d:[\"$\",\"li\",\"863663\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-58/\",\"children\":\"Chapter 58 Townships\"}]}]\n2e:[\"$\",\"li\",\"863706\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-59/\",\"children\":\"Chapter 59 Trusts\"}]}]\n2f:[\"$\",\"li\",\"863755\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-da"])</script><script>self.__next_f.push([1,"kota/t-60/\",\"children\":\"Chapter 60 Warehousing and Deposits\"}]}]\n30:[\"$\",\"li\",\"863775\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-61/\",\"children\":\"Chapter 61 Waters\"}]}]\n31:[\"$\",\"li\",\"863895\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/cct-62/\",\"children\":\"Chapter 62 Weapons\"}]}]\n32:[\"$\",\"li\",\"863910\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-63/\",\"children\":\"Chapter 63 Weeds\"}]}]\n33:[\"$\",\"li\",\"863924\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-64/\",\"children\":\"Chapter 64 Weights, Measures, and Grades\"}]}]\n34:[\"$\",\"li\",\"863933\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-65/\",\"children\":\"Chapter 65 Workforce Safety and Insurance\"}]}]\n35:[\"$\",\"li\",\"859952\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-121/\",\"children\":\"Chapter 12.1 Criminal Code\"}]}]\n36:[\"$\",\"li\",\"860400\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-151/\",\"children\":\"Chapter 15.1 Elementary and Secondary Education\"}]}]\n37:[\"$\",\"li\",\"860536\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-161/\",\"children\":\"Chapter 16.1 Elections\"}]}]\n38:[\"$\",\"li\",\"860710\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-201/\",\"children\":\"Chapter 20.1 Game, Fish, Predators, and Boating\"}]}]\n39:[\"$\",\"li\",\"861060\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-261/\",\"children\":\"Chapter 26.1 Insurance\"}]}]\n3a:[\"$\",\"li\",\"861578\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-301/\",\"children\":\"Chapter 30.1 Uniform Probate Code\"}]}]\n3b:[\"$\",\"li\",\"863897\",{\"children\":[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/t-621/\",\"children\":\"Chapter 62.1 Weapons\"}]}]\n3e:T2904,"])</script><script>self.__next_f.push([1,"\u003ca href=\"https://law.justia.com/codes/north-dakota/2009/t50/pdf/t50c246.pdf\"\u003eDownload pdf\u003c/a\u003e\u003cbr\u003e\u003cdiv id=\"embed_document\" style=\"width:625px; height:815px; text-align:center;\"\u003eLoading PDF...\u003c/div\u003e\u003cscript type=\"text/javascript\"\u003e var pdf_url = 'https://law.justia.com/codes/north-dakota/2009/t50/pdf/t50c246.pdf'; $(document).ready(function() { var embedwindow = $(\"#embed_document\"); if ($.browser.msie){ embedwindow.html('\u003cembed src=\"'+pdf_url+'\" width=\"100%\" height=\"100%\"\u003e\u003c/embed\u003e'); } else { embedwindow.html('\u003ciframe style=\"width:100%; height:100%;\" src=\"https://docs.google.com/gview?url='+window.escape(pdf_url)+'\u0026embedded=true\" frameborder=\"0\"\u003e\u003c/iframe\u003e'); } });\u003c/script\u003e\u003cbr\u003e\u003cbr\u003e\u003cnoframes\u003eCHAPTER 50-24.6MEDICAL ASSISTANCE DRUG USE REVIEW AND AUTHORIZATION50-24.6-01. Definitions. As used in this chapter, unless the context otherwise requires:1.\u0026quot;Board\u0026quot; means the drug use review board.2.\u0026quot;Compendium\u0026quot; means the American hospital formulary service drug information,\u003cbr\u003eUnited States pharmacopeia-drug information, the DRUGDEX information system,\u003cbr\u003eAmerican medical association drug evaluations, or nonproprietary peer-reviewed\u003cbr\u003emedical literature.3.\u0026quot;Department\u0026quot; means the department of human services.4.\u0026quot;Drug use review\u0026quot; means a program as described in 42 U.S.C. 1396r-8(g)(2).5.\u0026quot;Drug use review criteria\u0026quot; means standards approved by the board for use in\u003cbr\u003edetermining whether use of a drug is likely to be medically appropriate, to be\u003cbr\u003emedically necessary, and not result in adverse medical outcomes.6.\u0026quot;Prior authorization\u0026quot; means a process requiring the prescriber or the dispenser to\u003cbr\u003everify with the department or the department's contractor that proposed medical use\u003cbr\u003eof a particular drug for a medical assistance program recipient meets predetermined\u003cbr\u003ecriteria for coverage by the medical assistance program.50-24.6-02. Drug use review board.1.The board is established within the department for the implementation of a drug use\u003cbr\u003ereview program.2.The board consists of seventeen members.The pharmacy administrator of thedepartment and the medical consultant to the department are ex officio nonvoting\u003cbr\u003eboard members who shall provide administrative services to the board. A majority of\u003cbr\u003ethe appointed members must be physicians and pharmacists participating in the\u003cbr\u003emedical assistance program. Four or more of the appointed members must have\u003cbr\u003eexperience with a drug use review process or have participated in programs in which\u003cbr\u003eprior authorization is used. The appointed members of the board must be:a.Four physicians licensed in this state and actively engaged in the practice of\u003cbr\u003emedicine, one of whom is a psychiatrist, appointed by the North Dakota\u003cbr\u003emedical association;b.Two physicians licensed in this state and actively engaged in the practice of\u003cbr\u003emedicine, appointed by the executive director of the department;c.Four pharmacists licensed in this state and actively engaged in the practice of\u003cbr\u003epharmacy, appointed by the North Dakota pharmaceutical association;d.Two pharmacists licensed in this state and actively engaged in the practice of\u003cbr\u003epharmacy, appointed by the executive director of the department;e.One individual who represents consumer interests, appointed by the governor;f.One pharmacist or physician representing the brand pharmaceutical industry\u003cbr\u003eappointed by the pharmaceutical research and manufacturers of America; andg.One pharmacist or physician representing the generic pharmaceutical industry\u003cbr\u003eappointed by the generic pharmaceutical association.Page No. 13.Appointed board members shall serve staggered three-year terms. An appointed\u003cbr\u003emember may be reappointed for a period not to exceed three 3-year terms.Avacancy on the board must be filled for the balance of the unexpired term from the\u003cbr\u003eappropriate board category as provided under subsection 2. The executive director\u003cbr\u003eof the department may replace an appointed member of the board who fails to\u003cbr\u003eattend three consecutive meetings of the board without advance excuse or who fails\u003cbr\u003eto perform the duties expected of a board member. The pharmaceutical industry\u003cbr\u003erepresentatives are nonvoting board members.4.Voting board members shall select a chairman and a vice chairman on an annual\u003cbr\u003ebasis from the board's voting membership.5.The board shall meet in person at least once every three months and may meet at\u003cbr\u003eother times by teleconference or electronically at the discretion of the chairman. A\u003cbr\u003eboard member is entitled to receive from the department per diem compensation\u003cbr\u003eand reimbursement of expenses as determined by the department, except that no\u003cbr\u003ecompensation under this section may be paid to any board member who receives\u003cbr\u003ecompensation or salary as a state employee or official.50-24.6-03. Duties of the board. The board shall:1.Cooperate with the department to create and implement a prospective and\u003cbr\u003eretrospective drug use review program for outpatient prescription drugs under the\u003cbr\u003emedical assistance program. This drug use review program must be based on a\u003cbr\u003ecompendium and drug use review criteria and must comply with 42 U.S.C.\u003cbr\u003e1396r-8(g)(3).2.Advise and make recommendations regarding any rule proposed for adoption by the\u003cbr\u003edepartment to implement the provisions of state and federal law related to drug use\u003cbr\u003ereview.3.Receive and consider information regarding the drug use review process which is\u003cbr\u003eprovided by the department and by interested parties, including prescribers who\u003cbr\u003etreat significant numbers of patients under the department's medical assistance\u003cbr\u003eprogram.4.Review and recommend to the department any drugs to be included on prior\u003cbr\u003eauthorization status.5.Review no less than once each year the status of the list of drugs that have been\u003cbr\u003eplaced on prior authorization.6.Review and approve the prior authorization program process used by the\u003cbr\u003edepartment, including the process to accommodate the provision of a drug benefit in\u003cbr\u003ean emergency situation.7.Propose remedial strategies to improve the quality of care and to promote effective\u003cbr\u003euse of medical assistance program funds or recipient expenditures.50-24.6-04. Prior authorization program.1.The department shall develop and implement a prior authorization program that\u003cbr\u003emeets the requirements of 42 U.S.C. 1396r-8(d) to determine coverage of drug\u003cbr\u003eproducts when a medical assistance recipient's health care provider prescribes a\u003cbr\u003edrug that is identified as requiring prior authorization. Authorization must be granted\u003cbr\u003efor provision of the drug if:Page No. 2a.The drug not requiring prior authorization has not been effective, or with\u003cbr\u003ereasonable certainty is not expected to be effective, in treating the recipient's\u003cbr\u003econdition;b.The drug not requiring prior authorization causes or is reasonably expected to\u003cbr\u003ecause adverse or harmful reactions to the health of the recipient; orc.The drug is prescribed for a medically accepted use supported by a\u003cbr\u003ecompendium or by approved product labeling unless there is a therapeutically\u003cbr\u003eequivalent drug that is available without prior authorization.2.For any drug placed on the prior authorization program, the department shall provide\u003cbr\u003emedical and clinical criteria, cost information, and utilization data to the drug use\u003cbr\u003ereview board for review and consideration. The board may consider department\u003cbr\u003edata and information from other sources to make a decision about placement of the\u003cbr\u003edrug on prior authorization.3.Except for quantity limits that may be no less than the pharmaceutical\u003cbr\u003emanufacturer's package insert, or brand name drugs with a generic equivalent drug\u003cbr\u003efor which the cost to the state postrebate is less than the brand name drugs, in the\u003cbr\u003eaggregate, the department may not prior authorize the following medication classes:a.Antipsychotics;b.Antidepressants;c.Anticonvulsants;d.Antiretrovirals, for the treatment of human immunodeficiency virus;e.Antineoplastic agents, for the treatment of cancer; andf.Stimulant medication used for the treatment of attention deficit disorder and\u003cbr\u003eattention deficit hyperactivity disorder.4.The department may use contractors to collect and analyze the documentation\u003cbr\u003erequired under this section and to facilitate the prior authorization program.5.The department shall consult with the board in the course of adopting rules to\u003cbr\u003eimplement the prior authorization program. The rules must:a.Establishpoliciesandproceduresnecessarytoimplementthepriorauthorization program.b.Develop a process that allows prescribers to furnish documentation required to\u003cbr\u003eobtain approval for a drug without interfering with patient care activities.c.Allow the board to establish panels of physicians and pharmacists which\u003cbr\u003eprovide expert guidance and recommendations to the board in considering\u003cbr\u003especific drugs or therapeutic classes of drugs to be included in the prior\u003cbr\u003eauthorization program.50-24.6-05. Public notice - Applicability.1.The department shall provide thirty days' notice of all meetings of the board. The\u003cbr\u003enotice requirement is met if the department provides notice of the meeting on the\u003cbr\u003edepartment's web site and provides, by written or electronic means, individual notice\u003cbr\u003eto each person that has requested such notice. If the meeting agenda includes\u003cbr\u003eboard consideration of a change to the prior authorization program, the departmentPage No. 3shall include in the notice a list of the affected drugs, and upon request the board\u003cbr\u003eshall provide background information. Any interested party may attend a meeting of\u003cbr\u003ethe board and provide information or recommendations related to the inclusion of a\u003cbr\u003edrug in a prior authorization program.2.The department shall post on the department's web site:a.The most current and applicable list of drugs requiring prior authorization,\u003cbr\u003etogether with any limits on coverage of these drugs.b.In downloadable format, forms necessary to complete prior authorization\u003cbr\u003erequests.c.Decisions regarding changes to the prior authorization program list.Thedepartment shall allow a period of no less than thirty days for public comment\u003cbr\u003efollowing posting on the web site.d.Meeting notice.3.The department may not discontinue the provision of prescription drug benefits\u003cbr\u003ebeing provided to medical assistance recipients before April 14, 2003, based solely\u003cbr\u003eon the subsequent placement of the drug on the prior authorization program.50-24.6-06. Grievances. Expired under S.L. 2003, ch. 430,"])</script><script>self.__next_f.push([1,"3c:[\"$\",\"article\",null,{\"className\":\"article-content\",\"children\":[[\"$\",\"header\",null,{\"className\":\"article-header\",\"children\":[[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/\",\"className\":\"article-category\",\"children\":[\"North Dakota\",\" Statutes\"]}],[\"$\",\"h1\",null,{\"className\":\"article-title\",\"children\":\"50-24.6 Medical Assistance Drug Use Review and Authorization\"}]]}],[\"$\",\"div\",null,{\"className\":\"article-body statute-content\",\"dangerouslySetInnerHTML\":{\"__html\":\"$3e\"}}],false]}]\n"])</script><script>self.__next_f.push([1,"3d:[\"$\",\"aside\",null,{\"className\":\"right-sidebar\",\"children\":[\"$\",\"div\",null,{\"className\":\"related-sidebar\",\"children\":[[\"$\",\"h3\",null,{\"children\":[[\"$\",\"span\",null,{\"className\":\"emoji\",\"children\":\"⚖️\"}],\" State Laws\"]}],[\"$\",\"ul\",null,{\"className\":\"state-laws-list\",\"children\":[[\"$\",\"li\",\"state-of-alabama\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-alabama\",\"children\":[\"The State Laws of \",\"Alabama\"]}]}],[\"$\",\"li\",\"state-of-alaska\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-alaska\",\"children\":[\"The State Laws of \",\"Alaska\"]}]}],[\"$\",\"li\",\"state-of-arizona\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-arizona\",\"children\":[\"The State Laws of \",\"Arizona\"]}]}],[\"$\",\"li\",\"state-of-arkansas\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-arkansas\",\"children\":[\"The State Laws of \",\"Arkansas\"]}]}],[\"$\",\"li\",\"state-of-california\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-california\",\"children\":[\"The State Laws of \",\"California\"]}]}],[\"$\",\"li\",\"state-of-colorado\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-colorado\",\"children\":[\"The State Laws of \",\"Colorado\"]}]}],[\"$\",\"li\",\"state-of-connecticut\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-connecticut\",\"children\":[\"The State Laws of \",\"Connecticut\"]}]}],[\"$\",\"li\",\"state-of-delaware\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-delaware\",\"children\":[\"The State Laws of \",\"Delaware\"]}]}],[\"$\",\"li\",\"state-of-florida\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-florida\",\"children\":[\"The State Laws of \",\"Florida\"]}]}],[\"$\",\"li\",\"state-of-georgia\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-georgia\",\"children\":[\"The State Laws of \",\"Georgia\"]}]}],[\"$\",\"li\",\"state-of-hawaii\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-hawaii\",\"children\":[\"The State Laws of \",\"Hawaii\"]}]}],[\"$\",\"li\",\"state-of-idaho\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-idaho\",\"children\":[\"The State Laws of \",\"Idaho\"]}]}],[\"$\",\"li\",\"state-of-illinois\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-illinois\",\"children\":[\"The State Laws of \",\"Illinois\"]}]}],[\"$\",\"li\",\"state-of-indiana\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-indiana\",\"children\":[\"The State Laws of \",\"Indiana\"]}]}],[\"$\",\"li\",\"state-of-iowa\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-iowa\",\"children\":[\"The State Laws of \",\"Iowa\"]}]}],[\"$\",\"li\",\"state-of-kansas\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-kansas\",\"children\":[\"The State Laws of \",\"Kansas\"]}]}],[\"$\",\"li\",\"state-of-kentucky\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-kentucky\",\"children\":[\"The State Laws of \",\"Kentucky\"]}]}],[\"$\",\"li\",\"state-of-louisiana\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-louisiana\",\"children\":[\"The State Laws of \",\"Louisiana\"]}]}],[\"$\",\"li\",\"state-of-maine\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-maine\",\"children\":[\"The State Laws of \",\"Maine\"]}]}],[\"$\",\"li\",\"state-of-maryland\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-maryland\",\"children\":[\"The State Laws of \",\"Maryland\"]}]}],[\"$\",\"li\",\"state-of-massachusetts\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-massachusetts\",\"children\":[\"The State Laws of \",\"Massachusetts\"]}]}],[\"$\",\"li\",\"state-of-michigan\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-michigan\",\"children\":[\"The State Laws of \",\"Michigan\"]}]}],[\"$\",\"li\",\"state-of-minnesota\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-minnesota\",\"children\":[\"The State Laws of \",\"Minnesota\"]}]}],[\"$\",\"li\",\"state-of-mississippi\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-mississippi\",\"children\":[\"The State Laws of \",\"Mississippi\"]}]}],[\"$\",\"li\",\"state-of-missouri\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-missouri\",\"children\":[\"The State Laws of \",\"Missouri\"]}]}],\"$L3f\",\"$L40\",\"$L41\",\"$L42\",\"$L43\",\"$L44\",\"$L45\",\"$L46\",\"$L47\",\"$L48\",\"$L49\",\"$L4a\",\"$L4b\",\"$L4c\",\"$L4d\",\"$L4e\",\"$L4f\",\"$L50\",\"$L51\",\"$L52\",\"$L53\",\"$L54\",\"$L55\",\"$L56\",\"$L57\"]}]]}]}]\n"])</script><script>self.__next_f.push([1,"3f:[\"$\",\"li\",\"state-of-montana\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-montana\",\"children\":[\"The State Laws of \",\"Montana\"]}]}]\n40:[\"$\",\"li\",\"state-of-nebraska\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-nebraska\",\"children\":[\"The State Laws of \",\"Nebraska\"]}]}]\n41:[\"$\",\"li\",\"state-of-nevada\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-nevada\",\"children\":[\"The State Laws of \",\"Nevada\"]}]}]\n42:[\"$\",\"li\",\"state-of-new-hampshire\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-new-hampshire\",\"children\":[\"The State Laws of \",\"New Hampshire\"]}]}]\n43:[\"$\",\"li\",\"state-of-new-jersey\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-new-jersey\",\"children\":[\"The State Laws of \",\"New Jersey\"]}]}]\n44:[\"$\",\"li\",\"state-of-new-mexico\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-new-mexico\",\"children\":[\"The State Laws of \",\"New Mexico\"]}]}]\n45:[\"$\",\"li\",\"state-of-new-york\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-new-york\",\"children\":[\"The State Laws of \",\"New York\"]}]}]\n46:[\"$\",\"li\",\"state-of-north-carolina\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-north-carolina\",\"children\":[\"The State Laws of \",\"North Carolina\"]}]}]\n47:[\"$\",\"li\",\"state-of-north-dakota\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-north-dakota\",\"children\":[\"The State Laws of \",\"North Dakota\"]}]}]\n48:[\"$\",\"li\",\"state-of-ohio\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-ohio\",\"children\":[\"The State Laws of \",\"Ohio\"]}]}]\n49:[\"$\",\"li\",\"state-of-oklahoma\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-oklahoma\",\"children\":[\"The State Laws of \",\"Oklahoma\"]}]}]\n4a:[\"$\",\"li\",\"state-of-oregon\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-oregon\",\"children\":[\"The State Laws of \",\"Oregon\"]}]}]\n4b:[\"$\",\"li\",\"state-of-pennsylvania\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-pennsylvania\",\"children\":[\"The State Laws of \",\"Pennsylvania\"]}]}]\n4c:[\"$\",\"li\",\"state-of-rhode-island\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-rhode-island\",\"children\":[\"The State Laws of \",\"Rhode Island\"]}]}]\n4d:[\"$\",\"li\",\"state-of-south-carolina\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-south-carolina\",\"children\":[\"The State Laws of \",\"South Carolina\"]}]}]\n4e:[\"$\",\"li\",\"state-of-south-dakota\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-south-dakota\",\"children\":[\"The State Laws of \",\"South Dakota\"]}]}]\n4f:[\"$\",\"li\",\"state-of-tennessee\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-tennessee\",\"children\":[\"The State Laws of \",\"Tennessee\"]}]}]\n50:[\"$\",\"li\",\"state-of-texas\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-texas\",\"children\":[\"The State Laws of \",\"Texas\"]}]}]\n51:[\"$\",\"li\",\"state-of-utah\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-utah\",\"children\":[\"The State Laws of \",\"Utah\"]}]}]\n52:[\"$\",\"li\",\"state-of-vermont\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-vermont\",\"children\":[\"The State Laws of \",\"Vermont\"]}]}]\n53:[\"$\",\"li\",\"state-of-virginia\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-virginia\",\"children\":[\"The State Laws of \",\"Virginia\"]}]}]\n54:[\"$\",\"li\",\"state-of-washington\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-washington\",\"children\":[\"The State Laws of \",\"Washington\"]}]}]\n55:[\"$\",\"li\",\"state-of-west-virginia\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-west-virginia\",\"children\":[\"The State Laws of \",\"West Virginia\"]}]}]\n56:[\"$\",\"li\",\"state-of-wisconsin\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https://state-laws.laws.com/state-of-wisconsin\",\"children\":[\"The State Laws of \",\"Wisconsin\"]}]}]\n57:[\"$\",\"li\",\"state-of-wyoming\",{\"children\":[\"$\",\"a\",null,{\"href\":\"https:"])</script><script>self.__next_f.push([1,"//state-laws.laws.com/state-of-wyoming\",\"children\":[\"The State Laws of \",\"Wyoming\"]}]}]\n"])</script></body></html>
Loading PDF...