Panel hears testimony on bill to license and regulate PBMs; funding and ERISA risk debated

At a meeting of the Legislature’s Government Operations Division, members heard an extended hearing on House Bill 1584, a measure that would license pharmacy benefit managers and give the state insurance commissioner authority to enforce PBM practices in North Dakota.

The bill’s supporters told the panel they seek accountability and enforcement mechanisms after years of limited transparency in the PBM market. "One thing we haven't done…is looking for accountability, oversight and enforcement of the laws that we've been passing," said Mike Schwab, a representative of the North Dakota Pharmacists Association, who testified in support of the bill. Schwab described market concentration, rebate practices and spread pricing and cited audits and investigations in other states as examples of harms PBM critics contend justify regulation.

Supporters pointed to state history and existing funding that could help stand up oversight. Schwab and Mark Hardy, executive director of the North Dakota State Board of Pharmacy, said the 2021 drug pricing transparency law created a drug pricing fund funded by Board of Pharmacy license fees. Schwab said the fund currently holds about $1.6 million and that another roughly $600,000 is expected later in the biennium; the bill would make that funding available to support insurance‑department regulation.

John…