25 pharmacy benefit managers notified to comply in North Dakota

North Dakota Insurance Commissioner Jon Godfread notified 25 pharmacy benefit managers (PBMs) of apparent unlicensed activity in North Dakota. They have 20 days after receiving the notice to submit a complete license application before cease-and-desist orders are issued.

PBMs serve as middlemen between insurers, pharmacies and drug manufacturers. They influence prescription drug pricing, coverage and pharmacy reimbursement, affecting what North Dakotans pay for medications and the ability of local pharmacies to serve their communities.

The North Dakota Insurance and Securities Department has information indicating the PBMs are operating in the state without the required license. The notices provide an opportunity to come into compliance voluntarily. PBMs that submit a complete application within the 20-day period will have their applications processed in the ordinary course, and the Department will not issue a cease-and-desist order. PBMs that fail to meet the requirements will receive a cease-and-desist order and will incur further penalties and fines.

"These 25 notices demonstrate North Dakota's commitment to ensure accountability, protect consumers and make sure those operating in our state follow the law," Godfread said. "To help avoid further impact to consumers, we're giving the PBMs 20 days to comply before we take the next enforcement step."

The notices follow the passage of House Bill 1584 during the 2025 Legislative Assembly, which established a dedicated PBM Division within the Department and expanded the Commissioner's authority to investigate and enforce state laws governing PBM practices.

Licensing is a key part of the Department's oversight of PBMs. The Department will continue to review compliance and use its enforcement authority to protect North Dakota consumers.

For more information, visit insurance.nd.gov or call (701) 328-2440.