North Dakota 69-2025 Assembly Status: Enacted 4 R cosponsors

SB 2280 — Relating to prior authorization for health insurance; to provide for a legislative management study; to provide for a legislative management report; and to provide an effective date.

Last action — Filed with Secretary Of State 04/22

  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed Senate
  4. ✓
    Passed House
  5. ✓
    To Executive
  6. 6
    Enacted

This bill has been enacted into law. Introduced January 20, 2025. Enacted.

Signed by Governor Kelly Armstrong (Republican) on April 23, 2025.

Odds of enactment

High chance

Based on the sponsor, cosponsors, and committee posture, this bill has a high chance of becoming law.

Upgrade to see the exact probability and what's driving it.

A statistical estimate from our own model of past outcomes — an insight, not a guarantee. Policymaking is volatile.

Prognosis

Likely to advance 82% · moderate confidence

  • Enacted

    Current position in the legislative process.

  • 6 sponsors

    1 primary, 5 co-sponsors signed on.

  • Single-party support

    Sponsorship is currently within one party (4 R).

  • Cleared a recorded vote

    Passed 3 recorded votes so far.

Based on stage, sponsorship breadth, committee status, recorded votes, and cross-state momentum — a description of the observable signals, not a prediction.

Summary

AN ACT to create and enact chapter 26.1-36.12 of the North Dakota Century Code, relating to prior authorization for health insurance; to provide for a legislative management study; to provide for a legislative management report; and to provide an effective date.

Bill Text

What changed in the latest version

304 added · 318 removed

Plain-language change summary

The latest version of Senate Bill 2280 has removed references to "dental insurance" in its provisions concerning prior authorization for health services, narrowing its focus specifically to health insurance. This change is important because it signals a shift in policy, concentrating efforts on regulating health insurance practices first, potentially leaving dental coverage for a future discussion or separate legislation. By limiting the scope to health insurance, lawmakers can more thoroughly address issues related to prior authorizations that affect patient care and access to necessary medical services.

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25.1180.03000 Sixty-ninth Legislative Assembly of North Dakota FIRST ENGROSSMENT ENGROSSED SENATE BILL NO.
Sixty-ninth Legislative Assembly of North Dakota In Regular Session Commencing Tuesday, January 7, 2025 SENATE BILL NO.
2280 Introduced by Senators Meyer, Barta, Bekkedahl, Cleary Representatives Nelson, Warrey A BILL for an Act to create and enact chapter 26.1-36.12 of the North Dakota Century Code, relating to prior authorization for health and dental insurance;
2280 (Senators Meyer, Barta, Bekkedahl, Cleary) (Representatives Nelson, Warrey) AN ACT to create and enact chapter 26.1-36.12 of the North Dakota Century Code, relating to prior authorization for health insurance;
"Clinical criteria" means the written policies, written screening procedures, drug formularies or lists of covered drugs, determination rules, determination abstracts, clinical protocols, practice guidelines, medical protocols, and any other criteria or Page No.
"Clinical criteria" means the written policies, written screening procedures, drug formularies or lists of covered drugs, determination rules, determination abstracts, clinical protocols, practice guidelines, medical protocols, and any other criteria or rationale used by the prior authorization review organization to determine the necessity and appropriateness of health care services.
1 25.1180.03000 Sixty-ninth Legislative Assembly rationale used by the prior authorization review organization to determine the necessity and appropriateness of health care services.
"Health care services" means health care procedures, treatments, or services provided by a licensed facility or provided by a licensed physician, licensed dentist, or within the scope of practice for which a health care professional is licensed.
"Health care services" means health care procedures, treatments, or services provided by a licensed facility or provided by a licensed physician or within the scope of practice for which a health care professional is licensed.
The term includes dental services and the provision of pharmaceutical products or services or durable medical equipment.
The term includes the provision of pharmaceutical products or services or durable medical equipment.
9.
S.
"Medically necessary" as the term applies to health care services means health care services a prudent physician or dentist would provide to a patient for the purpose of preventing, diagnosing, or treating an illness, injury, disease, or its symptoms in a manner that is:
B.
NO.
2280 - PAGE 2 9.
"Medically necessary" as the term applies to health care services means health care services a prudent physician would provide to a patient for the purpose of preventing, diagnosing, or treating an illness, injury, disease, or its symptoms in a manner that is:
Not primarily for the economic benefit of the health plans and purchasers or for the convenience of the patient, treating physician, treating dentist, or other health care provider.
Not primarily for the economic benefit of the health plans and purchasers or for the convenience of the patient, treating physician, or other health care provider.
"Medication assisted treatment" means the use of medications, commonly in combination with counseling and behavioral therapies, to provide a comprehensive approach to the treatment of substance use disorders.
"Medication-assisted treatment" means the use of medications, commonly in combination with counseling and behavioral therapies, to provide a comprehensive approach to the treatment of substance use disorders.
United States food and drug administration-approved medications used to treat opioid addiction include methadone and buprenorphine, alone or in combination with naloxone and extended-release Page No.
United States food and drug administration-approved medications used to treat opioid addiction include methadone and buprenorphine, alone or in combination with naloxone and extended-release injectable naltrexone.
2 25.1180.03000 Sixty-ninth Legislative Assembly injectable naltrexone.
"Policy" means a health benefit plan as defined in section 26.1-36.3-01 or a dental benefit plan as defined in section 26.1-36.9-01.
"Policy" means a health benefit plan as defined in section 26.1-36.3-01.
"Urgent health care service" means a health care service for which, in the opinion of a health care professional with knowledge of the enrollee's medical condition, the application of the time periods for making a non-expedited prior authorization might:
"Urgent health care service" means a health care service for which, in the opinion of a health care professional with knowledge of the enrollee's medical condition, the application of the time periods for making a nonexpedited prior authorization might:
Page No.
26.1-36.12-02.
3 25.1180.03000 Sixty-ninth Legislative Assembly 26.1-36.12-02.
A prior authorization review organization shall make any prior authorization requirements and restrictions readily accessible on the organization's website to enrollees, health care professionals, and the general public.
A prior authorization review organization shall make any prior authorization requirements and restrictions readily accessible on the organization's website to enrollees, health care S.
B.
NO.
2280 - PAGE 3 professionals, and the general public.
A prior authorization review organization shall ensure all adverse determinations are made by a licensed physician, licensed dentist, or licensed pharmacist.
A prior authorization review organization shall ensure all adverse determinations are made by a licensed physician or licensed pharmacist.
A prior authorization review organization shall ensure all appeals are reviewed by a physician or dentist.
A prior authorization review organization shall ensure all appeals are reviewed by a physician.
Shall possess a valid nonrestricted license to practice medicine or dentistry;
Shall possess a valid nonrestricted license to practice medicine.
Must be in active practice in the same or similar specialty as the physician or dentist who typically manages the medical condition or disease for at least five consecutive years;
Must be in active practice in the same or similar specialty as the physician who typically manages the medical condition or disease for at least five consecutive years.
Page No.
c.
4 25.1180.03000 Sixty-ninth Legislative Assembly c.
Must be knowledgeable of, and have experience providing, the health care services under appeal.
Must be knowledgeable of, and have experience providing, the health care services under appeal;
May not be employed by a prior authorization review organization or be under contract with a prior authorization review organization other than to participate in one or more of the prior authorization review organization's health care provider networks or to perform reviews of appeals, or otherwise have any financial interest in the outcome of the appeal;
May not receive any financial incentive based on the number of adverse determinations made.
This subdivision does not apply to financial incentives established between health plan companies and health care providers.
May not have been directly involved in making the adverse determination;
May not have been directly involved in making the adverse determination.
and f.
f.
26.1-36.12-05.
3.
This section does not apply to reviews conducted under sections 26.1-36-44 and 26.1-36-46.
S.
B.
NO.
2280 - PAGE 4 26.1-36.12-05.
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For purposes of this subsection, "necessary information" includes the results of any face-to-face clinical evaluation or second opinion that may be required.
For purposes of this section, "necessary information" includes the results of any face-to-face clinical evaluation or second opinion that may be required.
A prior authorization review organization shall allow an enrollee and the enrollee's health care provider fourteen business days following a nonurgent circumstance or provision of health care services for the enrollee or health care provider to notify the prior authorization review organization of the nonurgent circumstance or provision of health care services.
A prior authorization review organization shall have written procedures to address the failure of a health care provider or enrollee to provide the necessary information to make a determination on the request.
Page No.
If the health care provider or enrollee fails to provide the necessary information to the prior authorization review organization within fourteen calendar days of a written request for all necessary information, the prior authorization review organization may make an adverse determination.
5 25.1180.03000 Sixty-ninth Legislative Assembly 26.1-36.12-06.
3.
A prior authorization review organization shall allow an enrollee and the enrollee's health care provider at least fourteen business days to request an updated prior authorization following an unforeseen change in the circumstances or care needs for the enrollee following a nonurgent circumstance or provision of health care services for the enrollee.
26.1-36.12-06.
No prior authorization for medication assisted treatment.
No prior authorization for medication-assisted treatment.
A prior authorization review organization may not require prior authorization for the provision of medication assisted treatment for the treatment of opioid use disorder.
A prior authorization review organization may not require prior authorization for the provision of medication-assisted treatment for the treatment of opioid use disorder.
26.1-36.12-09.
S.
B.
NO.
2280 - PAGE 5 26.1-36.12-09.
Page No.
26.1-36.12-10.
6 25.1180.03000 Sixty-ninth Legislative Assembly 26.1-36.12-10.
A prior authorization is valid for six months after the date the health care provider receives the prior authorization.
A prior authorization is valid for at least six months after the date the health care provider receives the prior authorization.
On receipt of information documenting a prior authorization from the enrollee or from the enrollee's health care provider, a prior authorization review organization shall honor a prior authorization granted to an enrollee from a previous prior authorization review organization for at least the initial sixty days of an enrollee's coverage under a new policy.
On receipt of information documenting a prior authorization from the enrollee or from the enrollee's health care provider, a prior authorization review organization shall honor a prior authorization granted to an enrollee from a previous prior authorization review organization for at least the initial sixty days of an enrollee's coverage under a new policy, provided the health care service for which the enrollee has received prior authorization is covered under the new policy.
To obtain coverage, the enrollee or health care provider shall submit documentation of the previous prior authorization in accordance with the procedures in the enrollee's new policy.
A prior authorization review organization shall continue to honor a prior authorization the organization has granted to an enrollee if the enrollee changes products under the same health insurance company.
A prior authorization review organization shall continue to honor a prior authorization the organization has granted to an enrollee if the enrollee changes products under the same health insurance company provided the health care service for which the enrollee has received prior authorization is covered under the new policy.
Page No.
26.1-36.12-14.
7 25.1180.03000 Sixty-ninth Legislative Assembly 26.1-36.12-14.
2.
S.
B.
NO.
2280 - PAGE 6 2.
Page No.
b.
8 25.1180.03000 Sixty-ninth Legislative Assembly b.
and h.
and S.
B.
NO.
2280 - PAGE 7 h.
Page No.
b.
9 25.1180.03000 Sixty-ninth Legislative Assembly b.
LEGISLATIVE MANAGEMENT STUDY - PRIOR AUTHORIZATION ELECTRONIC HEALTH RECORDS FOR NONURGENT AND EMERGENCY HEALTH CARE SERVICES.
During the 2025-26 interim, the legislative management shall consider studying the ability for health care systems and providers to submit prior authorization reviews for nonurgent and emergency health care services by secure electronic means.
The study must analyze alternatives to facsimile or mail for transmitting prior authorization requests and the supporting medical records.
The study must include input from stakeholders, including patients, providers, and commercial insurance plans.
The legislative management shall report its findings and recommendations, together with any legislation required to implement the recommendations, to the seventieth legislative assembly.
SECTION 4.
Page No.
S.
10 25.1180.03000
B.
NO.
2280 - PAGE 8 ____________________________ ____________________________ President of the Senate Speaker of the House ____________________________ ____________________________ Secretary of the Senate Chief Clerk of the House This certifies that the within bill originated in the Senate of the Sixty-ninth Legislative Assembly of North Dakota and is known on the records of that body as Senate Bill No.
2280.
Senate Vote:
Yeas 43 Nays 3 Absent 1 House Vote:
Yeas 93 Nays 0 Absent 1 ____________________________ Secretary of the Senate Received by the Governor at ________M.
on _____________________________________, 2025.
Approved at ________M.
on __________________________________________________, 2025.
____________________________ Governor Filed in this office this ___________day of _______________________________________, 2025, at ________ o’clock ________M.
____________________________ Secretary of State
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Action History

  1. Filed with Secretary Of State 04/22

  2. Signed by Governor 04/21

  3. Sent to Governor

  4. Signed by President

  5. Signed by Speaker

  6. Second reading, passed, yeas 43 nays 3

  7. Concurred

  8. Returned to Senate (12)

  9. Second reading, passed as amended, yeas 93 nays 0

  10. Amendment adopted, placed on calendar

  11. Reported back amended, do pass, amendment placed on calendar 10 0 4

  12. Committee Hearing 09:45

  13. Committee Hearing 02:30

  14. Introduced, first reading, referred Industry, Business and Labor Committee

  15. Received from Senate

  16. Second reading, passed, yeas 43 nays 4

  17. Amendment adopted, placed on calendar

  18. Reported back amended, do pass, amendment placed on calendar 5 0 0

  19. Committee Hearing 02:30

  20. Introduced, first reading, referred Industry and Business Committee

Sponsors

Sponsorship breakdown

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1 sponsors · 5 co-sponsors · 142 not signed on · 5 voted No

Sponsors (1)

Co-sponsors (5)

Not signed on (142)

142 members have not signed on to this bill.

Show all 142 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

Final Passage

Passed 43 Yea · 3 Nay · 1 Other
Party YeaNayPresentNot Voting
Republican 37301
Democratic 5000
Unaffiliated 1000
Total 43301
% of votes cast 91%6%0%2%
How each member voted (47)
Member Party Vote
van Oosting — Yea
Boschee, Josh Democratic Yea
Braunberger, Ryan Democratic Yea
Hogan, Kathy Democratic Yea
Marcellais, Richard Democratic Yea
Mathern, Tim Democratic Yea
Axtman, Michelle Republican Yea
Barta, Jeff Republican Yea
Beard, Todd Republican Yea
Bekkedahl, Brad Republican Not Voting
Boehm, Keith Republican Yea
Burckhard, Randy A. Republican Yea
Castaneda, Jose L. Republican Yea
Cleary, Sean Republican Yea
Clemens, David A. Republican Yea
Conley, Cole Republican Yea
Cory, Claire Republican Yea
Davison, Kyle Republican Yea
Dever, Dick Republican Yea
Dwyer, Michael Republican Yea
Enget, Mark Republican Yea
Erbele, Robert Republican Yea
Gerhardt, Justin Republican Yea
Hogue, David Republican Yea
Kessel, Greg Republican Yea
Klein, Jerry Republican Yea
Larson, Diane Republican Yea
Lee, Judy Republican Yea
Lemm, Randy D. Republican Yea
Luick, Larry Republican Yea
Magrum, Jeffery J. Republican Nay
Meyer, Scott Republican Yea
Myrdal, Janne Republican Yea
Patten, Dale Republican Yea
Paulson, Bob Republican Yea
Powers, Michelle Republican Nay
Roers, Kristin Republican Nay
Rummel, Dean Republican Yea
Schaible, Donald Republican Yea
Sickler, Jonathan Republican Yea
Sorvaag, Ronald Republican Yea
Thomas, Paul J. Republican Yea
Walen, Chuck Republican Yea
Wanzek, Terry M. Republican Yea
Weber, Mark F. Republican Yea
Weston, Kent Republican Yea
Wobbema, Mike Republican Yea

Official roll call →

Final Passage

Passed 93 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Republican 81001
Democratic 11000
Unaffiliated 1000
Total 93001
% of votes cast 99%0%0%1%
How each member voted (94)
Member Party Vote
Olson — Yea
Brown, Collette Democratic Yea
Conmy, Liz Democratic Yea
Davis, Jayme Democratic Yea
Dobervich, Gretchen Democratic Yea
Finley-DeVille, Lisa Democratic Yea
Foss, Austin Democratic Yea
Hager, LaurieBeth Democratic Yea
Hanson, Karla Rose Democratic Yea
Ista, Zachary Democratic Yea
Mitskog, Alisa Democratic Yea
Schneider, Mary Democratic Yea
Anderson, Bert Republican Yea
Anderson, Dick Republican Yea
Anderson, Karen A. Republican Yea
Bahl, Landon Republican Yea
Beltz, Mike Republican Yea
Berg, Mike Republican Yea
Bolinske, Macy Republican Yea
Bosch, Glenn Republican Yea
Brandenburg, Mike Republican Yea
Brown, TJ Republican Yea
Christianson, Nels Republican Yea
Dockter, Jason Republican Yea
Dressler, Ty Republican Yea
Fegley, Clayton Republican Yea
Fisher, Jay Republican Yea
Frelich, Kathy Republican Yea
Grindberg, Karen Republican Yea
Grueneich, Jim Republican Yea
Hagert, Jared C. Republican Yea
Hatlestad, Patrick R. Republican Yea
Hauck, Dori Republican Yea
Headland, Craig Republican Yea
Heilman, Matthew Republican Yea
Heinert, Pat D. Republican Yea
Henderson, Donna Republican Yea
Hendrix, Jared Republican Yea
Holle, Dawson Republican Yea
Hoverson, Jeff Republican Yea
Johnson, Jorin Republican Yea
Johnston, Daniel Republican Yea
Jonas, Jim Republican Yea
Karls, Karen Republican Yea
Kasper, Jim Republican Yea
Kempenich, Keith Republican Yea
Kiefert, Dwight Republican Yea
Klemin, Lawrence R. Republican Yea
Koppelman, Ben Republican Yea
Lefor, Mike Republican Yea
Longmuir, Donald W. Republican Yea
Louser, Scott Republican Yea
Maki, Roger A. Republican Yea
Marschall, Andrew Republican Yea
Martinson, Bob Republican Yea
McLeod, Carrie Republican Yea
Meier, Lisa Republican Yea
Monson, David Republican Yea
Morton, Desiree Republican Yea
Motschenbacher, Mike Republican Yea
Murphy, Eric J. Republican Yea
Nathe, Mike Republican Yea
Nehring, Dennis Republican Yea
Nelson, Jon O. Republican Yea
Novak, Anna S. Republican Yea
O'Brien, Emily Republican Yea
Olson, Jeremy Republican Yea
Osowski, Doug Republican Yea
Ostlie, Mitch Republican Yea
Porter, Todd Republican Yea
Pyle, Brandy L. Republican Yea
Richter, David Republican Yea
Rios, Nico Republican Yea
Rohr, Karen M. Republican Yea
Ruby, Dan Republican Yea
Ruby, Matthew Republican Yea
Sanford, Mark Republican Yea
Satrom, Bernie Republican Yea
Schatz, Mike Republican Yea
Schauer, Austen Republican Yea
Schreiber-Beck, Cynthia Republican Yea
Steiner, Vicky Republican Yea
Stemen, Gregory Republican Yea
Swiontek, Steve Republican Yea
Toman, Nathan Republican Yea
Tveit, Bill Republican Yea
VanWinkle, Lori Republican Not Voting
Vetter, Steve Republican Yea
Vigesaa, Don Republican Yea
Vollmer, Daniel R. Republican Yea
Wagner, Scott Republican Yea
Warrey, Jonathan Republican Yea
Weisz, Robin Republican Yea
Wolff, Christina Republican Yea

Official roll call →

Final Passage

Passed 43 Yea · 4 Nay
Party YeaNayPresentNot Voting
Republican 37400
Democratic 5000
Unaffiliated 1000
Total 43400
% of votes cast 91%9%0%0%
How each member voted (47)
Member Party Vote
van Oosting — Yea
Boschee, Josh Democratic Yea
Braunberger, Ryan Democratic Yea
Hogan, Kathy Democratic Yea
Marcellais, Richard Democratic Yea
Mathern, Tim Democratic Yea
Axtman, Michelle Republican Yea
Barta, Jeff Republican Yea
Beard, Todd Republican Yea
Bekkedahl, Brad Republican Yea
Boehm, Keith Republican Yea
Burckhard, Randy A. Republican Yea
Castaneda, Jose L. Republican Yea
Cleary, Sean Republican Yea
Clemens, David A. Republican Yea
Conley, Cole Republican Yea
Cory, Claire Republican Yea
Davison, Kyle Republican Yea
Dever, Dick Republican Yea
Dwyer, Michael Republican Yea
Enget, Mark Republican Yea
Erbele, Robert Republican Yea
Gerhardt, Justin Republican Yea
Hogue, David Republican Yea
Kessel, Greg Republican Yea
Klein, Jerry Republican Yea
Larson, Diane Republican Yea
Lee, Judy Republican Yea
Lemm, Randy D. Republican Yea
Luick, Larry Republican Yea
Magrum, Jeffery J. Republican Nay
Meyer, Scott Republican Yea
Myrdal, Janne Republican Yea
Patten, Dale Republican Nay
Paulson, Bob Republican Yea
Powers, Michelle Republican Yea
Roers, Kristin Republican Nay
Rummel, Dean Republican Yea
Schaible, Donald Republican Yea
Sickler, Jonathan Republican Yea
Sorvaag, Ronald Republican Yea
Thomas, Paul J. Republican Nay
Walen, Chuck Republican Yea
Wanzek, Terry M. Republican Yea
Weber, Mark F. Republican Yea
Weston, Kent Republican Yea
Wobbema, Mike Republican Yea

Official roll call →

Subjects

healthcare health-insurance
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Frequently asked questions

What does SB 2280 do?
AN ACT to create and enact chapter 26.1-36.12 of the North Dakota Century Code, relating to prior authorization for health insurance; to provide for a legislative management study; to provide for a legislative management report; and to provide an effective date.
Who sponsors SB 2280?
SB 2280 is sponsored by Meyer, Scott (Republican), Barta, Jeff (Republican), Bekkedahl, Brad (Republican), Cleary, Sean (Republican), Rep. Nelson, Jon O., and Rep. Warrey, Jonathan.
What is the current status of SB 2280?
This bill has been enacted into law. Introduced January 20, 2025. Enacted.
Where can I track SB 2280?
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