Click play to listen to this article.

A new North Dakota law that took effect January 1 makes it so health insurers must respond to prior authorization requests in a timely fashion.

The changes follow reforms seen elsewhere in the country, and advocates hope they'll reduce treatment delays for patients. Prior authorization involves a doctor seeking advance coverage approval of a medical treatment for their patient.

The practice has become widespread as insurers try to contain costs. But physicians and health advocacy groups say it can be burdensome and disrupt care options.

Image

Fargo resident Emily Bakkum testified in support of new state-level deadlines for insurers, and said they'll guarantee more timely access to treatment.

"It's super important that there's some kind of consistency," said Bakkum, "and that people aren't waiting."

Bakkum was inspired to speak up in honor of her late cousin, whose care team ran into hurdles after a cancer diagnosis.

Under North Dakota's new law, insurance plans have seven calendar days to provide a decision for non-urgent prior authorization requests and 72 hours for urgent requests. The law received bipartisan support but saw pushback from the insurance industry, with lobbyists warning of unintended consequences.

State Senator Senator Scott Meyer, R-Grand Forks, sponsored the bill last session, and he said it was important to take a stand for patients. He also pointed to provisions that cover the review process for denials – keeping it largely in the hands of medical professionals, rather than a business analyst.

Some skeptics say these moves will push costs higher, but Meyer argued reducing administrative tasks will result in less stress on the system.

"You know, you have doctors and others just chasing down prior authorization," said Meyer. "When they're doing those types of things, there's a cost that comes with it."

AARP is part of a broad coalition supporting the new law, with the group praising the guardrails that were added.

Essentia Health, which provides care in North Dakota, also backs the changes. It cites a 2023 survey from the American Medical Association revealing that physicians and their staff spend an average of 14 hours each week to complete prior authorization requests.

Ninety-two-percent of physicians also reported seeing delays in care.