North Dakota Enacts Prior Authorization Law to Curb Health Coverage Delays

North Dakota Governor Kelly Armstrong has signed a new law aimed at streamlining the health insurance prior authorization process, reducing care delays for patients across the state. Senate Bill 2280, signed during an April 23 ceremony at the Capitol, sets new standards to ensure timely insurance approvals for medical procedures and prescriptions.

The legislation introduces mandatory response deadlines for insurers, mandates that medical professionals review any denials, and prohibits requiring prior authorization for emergency care. Patients and providers will now have at least two business days to notify insurers after an emergency procedure.

Supporters, including Bismarck resident Susan Finneman, testified about the dangers of delayed care. Finneman recounted nearly missing critical spinal surgery due to insurance delays. "It’s not right that people have to figure out how to navigate it on their own," she said.

Although major insurers reportedly comply with reasonable prior authorization practices, concerns persist about inconsistent standards across companies. A 2024 American Medical Association survey found that 93% of physicians reported care delays due to prior authorization.

Opponents, including representatives from Blue Cross Blue Shield, argue the law could add bureaucracy and drive up insurance costs. Nonetheless, the law will take effect January 1, 2026, requiring insurers to report annual prior authorization data, including the number of approvals and denials, and the reason requests were denied. This data will also allow lawmakers to study potential improvements for future legislative sessions.

Reference

Steurer M. Bill signed this week seeks to prevent health coverage delays for North Dakota patients. North Dakota Monitor. April 25, 2025. Accessed April 28, 2025. https://www.kvrr.com/2025/04/25/bill-signed-this-week-seeks-to-prevent-health-coverage-delays-for-north-dakota-patients/