House approves bill requiring third‑party copayment assistance to count toward insurers' out‑of‑pocket totals

The North Dakota House of Representatives passed House Bill 1216 on final consideration, 69‑24, moving a measure that changes how insurers treat third‑party co‑payment assistance for prescription drugs.

Supporters and opponents sparred for more than an hour over whether manufacturer or charitable assistance that reduces a patient’s cost at the pharmacy should also count toward the patient’s insurance deductible and coinsurance. Representative Carls, the bill sponsor on the floor, framed the measure as a fix for patients who were effectively charged twice when insurers declined to credit third‑party assistance toward deductibles. "All payments must count, not some, all," Representative Carls said on the floor.

The House considered an amendment offered on the floor to require co‑payment assistance be applied to a patient’s pharmacy cost but not count toward the plan deductible for other…