[{"_1":2,"_88":-5,"_89":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6325054,"mediaKeyId","2334957-b85b50cc71e5f21d86b0219dc9a96868","parentId",2334957,"title","Hospitals and pharmacies debate 340B reporting amendments; committee delays HB1473","audioSeconds",150,"startMs",1745000,"endMs",1895000,"viewUrl","/Search/View?dp=1&key=2334957-b85b50cc71e5f21d86b0219dc9a96868&start=1745&end=1895","thumbnailUrl","https://assets.pipeline.soar.com/2334957-b85b50cc71e5f21d86b0219dc9a96868/thumbnail_1745000.jpg","articleUrl","/articles/6325054/North-Dakota/Hospitals-and-pharmacies-debate-340B-reporting-amendments-committee-delays-HB1473","mediaUrl","https://secure.pipeline.soar.com/6325054-8e78ed05de2ba701976bf25b3b2b767f/orig.mp4?Expires=1770444011&Signature=X7p8qAkh15j4Gnyv3xYugt-d9LX3kB7a~fZYL1-SUlXug99KGALHUmnO1ciilfemHUPRk5EniXrve3KT3XI8a087ZlN4QbMiuoY~ZPFDio9Kk24aW2vB~zE70WmA2LIuOrCOreejYTX8sfR41mikZNXMFno-NwR-VBJzMnx45Iy2ae2h0zS5wSd7S9tCKuKRapg80TrcwjPdFlBPrhVxDR4fe0WI4FqLX-~kjyPPN0jpUL5avZNbDk59HOSRdE0kQTTy3S2zNRvCFIflGcY28tzlzq~nCFSfmevNI0iGRtd6X-DeP8hW6pduC4wwulIW64vvgBhJtEK2P6JybDIygg__&Key-Pair-Id=KUT5TJCACFTXG","author","North Dakota State Legislature","date","2025-02-18T00:00:00Z","article","Stakeholders and lawmakers debated revisions to House Bill 1473, a measure tied to the federal 340B drug-pricing program and the use of contract pharmacies, but the House Committee on Industry, Business and Labor did not take final action and deferred further consideration.

Tim Blazell of the North Dakota Hospital Association and Andy Askew, vice president of public policy at Accenture Health, told the committee 340B is essential to keeping services open in rural communities. “This is a really important program for not just Accenture Health, but rural hospitals across North Dakota,” Askew said, noting Accenture Health operates 14 hospitals across Minnesota, North Dakota and Wisconsin and that critical access hospitals rely on contract pharmacies to dispense drugs the hospitals purchase through 340B discounts.

Askew presented an amendment that would require annual reporting to the Department of Health and Human Services describing how hospitals use savings from the 340B program to fund community programs and services, workforce, and to cover shortfalls in Medicare and Medicaid payments. He said the amendment aims to present a “holistic picture of how 340B is used” without imposing onerous data-sharing conditions.

Representative Schauer questioned the program’s original purpose, noting congressional language linking 340B to providers that serve low-income and underinsured patients. Askew replied that the statutory and committee history emphasize using 340B savings to “stretch federal resources to ensure access to comprehensive care,” and that federal audits already provide oversight. He challenged opponents to point to binding authority that restricts 340B savings to only charity care.

Representative Koppelman and others pressed for concrete data the committee can use: the share of prescriptions dispensed under 340B (excluding Medicare Part D), dollar savings per hospital, and how much of those savings are passed to contract pharmacies. Askew said his amendment did not include every specific data point lawmakers might request but that it was intended to provide meaningful transparency while protecting program functionality.

Mike Schwab of the North Dakota Pharmacists Association described how contract pharmacies and addenda can change pricing terms mid-contract and said the amendment’s opt-out provisions would give pharmacists a chance to exit unfavorable contract changes.

Tim Blazell said some hospital members viewed alternative amendments from drug manufacturers as effectively “gutting the bill” and that hospitals opposed reporting approaches that would require invasive data sharing with manufacturers. Committee members agreed to continue discussion and scheduled HB1473 for further consideration at the next meeting; Chairman Warray said parties would have additional time to share information.

The committee adjourned without taking a vote on HB1473 and planned to reconvene the following day to resume consideration of the bill and related items.","mediaType","Video","parentTitle","House Industry, Business and Labor Tuesday, Feb 18, 2025 3:06 PM - 3:57 PM","oneSentenceSummary","Stakeholders and lawmakers debated proposed reporting requirements tied to HB1473 and the 340B program; hospitals urged narrower reporting, while advocates for reporting sought data on program use. Committee deferred action to a later session.","taxTitle","Industry, Business and Labor, House of Representatives, Legislative, North Dakota","taxId",28894,"location","North Dakota","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6325059,"Committee amends HB1584 to create separate PBM license class; bill passes out of committee",695,363000,1058000,"/Search/View?dp=1&key=2334957-b85b50cc71e5f21d86b0219dc9a96868&start=363&end=1058","https://assets.pipeline.soar.com/2334957-b85b50cc71e5f21d86b0219dc9a96868/thumbnail_363000.jpg","/articles/6325059/North-Dakota/Committee-amends-HB1584-to-create-separate-PBM-license-class-bill-passes-out-of-committee","https://secure.pipeline.soar.com/6325059-4e73a3a996f4d16de0fc1e0dc79d1e3f/orig.mp4?Expires=1770444012&Signature=VrYC5KRDjJL~PKl3FpmohkDp24UZTKVW2yJ-RwlmjVDqTF6UB6han2N293UlfDoXdDQMFRyCNIWOfvjrje~OjIgbDe8vqpPD3azACu87U-1dKZ65fhYX5K8CN~9m8Ozeg9ycr3HoMtbKKWbgZk7C3nVkWXEfenadB7DxgVz0YVEWjSZb-FcdA82U-SKct-CE9dPHN3jQToY1zGN62ANIJS9WCCzR~tLTjqpDXpr0gndPES5mw7FrdQ6TscqntBxYLouyGGBD53h~WlQOfVfJYAS5tczoesBNJ5PXlZi97XpTzigRaZi3TxWTn~Y08ud7hsnA6iGQrQnOUTpOAjitAg__&Key-Pair-Id=KUT5TJCACFTXG","The House Committee on Industry, Business and Labor voted to pass House Bill 1584 as amended, adopting a new licensing class for pharmacy benefit managers and Representative Casper’s narrower definition of PBMs.

The amendments — one establishing a distinct license category for PBMs and one providing a revised definition of “pharmacy benefit manager” that Representative Casper offered — were combined and adopted before the committee voted on the bill. Representative Casper moved to adopt both amendments; Representative Koppelman moved that the committee “do pass as amended” on House Bill 1584, with a second from Representative Shots. The motion passed on a roll-call vote.

The amended measure creates a separate licensure class for PBMs, distinct from the third-party administrator (TPA) license the entities now commonly hold. John Arnold, Deputy Insurance Commissioner, told the committee the insurance department borrowed language from West Virginia to craft the licensing provision and kept the initial and renewal fees aligned with current TPA fees “with the idea that then that would be revenue neutral.” Arnold said the draft uses a $250 initial fee and a $100 renewal fee as placeholders to avoid additional short-term fiscal questions.

Representative Casper, who circulated a definition of PBM on the floor and urged the committee to adopt it, said the definition clarifies the bill’s scope and, in his view, avoids unintended impacts on self-funded plans. “It appears to me to be full of misinformation,” Casper said in response to an outside submission he received during floor session, and he urged the committee to rely on the filed court rulings and testimony presented. Casper also argued the legislation strengthens the state’s position should litigation follow: “By having those safeguards in place, it’ll help strengthen our arguments if it does come to that.”

Committee members asked how licensing would affect oversight. Arnold said the separate license class lets regulators “know exactly what the universe of PBMs looks like instead of the universe of TPAs,” and therefore which entities are subject to the bill’s provisions. He acknowledged that if the insurance department assumes regulatory responsibility it will likely need additional staff and resources, and that fee levels and funding could be revisited with Senate counterparts.

The committee briefly discussed the bill’s fiscal elements. Arnold confirmed the insurance department removed an appropriation request so the committee could consider the licensure language without triggering immediate fiscal referrals. He said an appropriations decision could be revisited later in the process.

Representative Koppelman, who moved the final do-pass motion, told colleagues the work on PBM regulation has been ongoing for many years and that prior state legislation and court wins provide background for the current draft. Supporters on the floor argued the bill will protect insurers, pharmacists and consumers by increasing oversight and transparency.

The committee’s roll-call recorded affirmative votes from a majority of members present and the clerk completed the tally at the meeting’s close. Committee leadership said Representative Casper may carry the bill to the floor if final procedural conditions are met.

The committee paused work to continue other bills and scheduled follow-up vetting between the House and the insurance department as needed.","The House committee accepted an amended version of House Bill 1584 that adds a separate licensing class for pharmacy benefit managers, adopts Representative Casper’s definition narrowing the bill’s scope, and passed the bill as amended on a roll-call vote.","actionData","errors"]

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Hospitals and pharmacies debate 340B reporting amendments; committee delays HB1473

Committee amends HB1584 to create separate PBM license class; bill passes out of committee