ND SB2280

Creates new regulations for health insurance prior authorization in North Dakota, requiring decisions on non-urgent requests within 7 calendar days, urgent requests within 72 hours, and prohibiting prior authorization for emergency services and medication-assisted treatment for opioid use disorder

Requires all adverse determinations (denials) to be made by licensed physicians or pharmacists with relevant experience, and appeals must be reviewed by physicians in active practice for at least 5 consecutive years in the same specialty

Establishes minimum authorization validity periods of 6 months for standard services and 12 months for chronic or long-term care conditions, with protections against retrospective denials within 45 business days

Mandates prior authorization review organizations publish requirements on their websites, provide 60 days written notice before implementing new requirements, and submit annual reports to the insurance commissioner detailing approval rates, denial reasons, and appeal outcomes

Directs legislative management to study prior authorization requirements for public employee retirement system insurance plans and electronic submission alternatives during the 2025-26 interim, with the law taking effect January 1, 2026