Committee Hears Broad Testimony on Senate Bill 2280 to Reform Prior Authorization for Health and Dental Insurance

Senate Industry and Business Committee Chairman Kentin Barta convened a hearing on Senate Bill 2280, a measure that would regulate prior authorization procedures for health and dental insurance plans in North Dakota, drawing extensive testimony from medical providers, patient advocates, hospitals, insurers and industry groups.

The bill’s sponsor, State Senator Scott Myers, asked the committee for a “due pass recommendation” and said the proposal "aims to reform and streamline the prior authorization process" after an interim study and stakeholder engagement. He circulated one narrow definitional amendment and asked the committee to consider the measure.

The bill would: require insurers or "prior authorization review organizations" to post prior-authorization requirements online in plain language; require that adverse determinations and appeals be made or reviewed by a licensed physician or dentist of the same or similar specialty; set statutory timelines for decisions; deem requests authorized if a reviewer misses the decision deadline; and require annual data reporting to the state insurance department including number of requests, approvals, adverse determinations and appeals overturn rates.

Andy Askew, vice president of public policy for an integrated health system, summarized the bill’s intent: "This bill's approach is simple, implement a reasonable regulatory framework that standardizes the prior authorization process for North Dakotans and align it with the best practices adopted throughout the country." He walked the committee through key provisions including definitions of "medically necessary," the 24-hour (urgent) and two-business-day (nonurgent) decision windows as drafted in the bill, the requirement that reviewers be licensed in the applicable clinical field, and the reporting mandate.

Multiple providers and patient advocates testified in support. Dentist Brad Beckall urged the committee to require that "all…