Commissioner Godfried advocates for unified PBM regulation amid staffing concerns

In a recent meeting of the North Dakota Senate Appropriations - Government Operations Division, discussions centered on the regulation of Pharmacy Benefit Managers (PBMs) highlighted the need for flexibility and adequate resources as the state prepares to implement new regulatory measures. The meeting, held on April 8, 2025, revealed significant concerns regarding the capacity of the state’s regulatory framework to handle the anticipated workload associated with PBM oversight.

Key speakers emphasized the importance of establishing a single entity responsible for PBM regulation, arguing that fragmented oversight could hinder effective enforcement. The need for additional staffing was a recurring theme, with estimates suggesting that at least two attorneys and potentially more would be necessary to manage the legal complexities involved. This concern was underscored by examples from other states, such as Oklahoma, which had to request additional personnel after implementing similar regulations.

The discussion also touched on the financial implications of these regulatory efforts. A fiscal note presented during the meeting indicated an estimated expenditure of $2.25 million to support the staffing needs, which would include pharmacists and examiners to address the expected influx of complaints from pharmacists regarding PBM practices. The volume of complaints has been significant in states like Kentucky, where regulatory staff reported receiving thousands of complaints monthly, indicating a pressing need for adequate resources to manage these issues effectively.

As the meeting concluded, the sentiment among participants was one of cautious optimism, with a recognition that while the regulatory framework is still being established, the commitment to ensuring effective oversight of PBMs is crucial for the health care system in North Dakota. The discussions set the stage for further legislative action, with stakeholders eager to see how the state will balance the need for regulation with the resources required to implement it successfully.