A bill to reform “prior authorization” has passed both the North Dakota House and Senate.
“Prior Authorization” means physicians must obtain approval from insurance companies before they can move forward with treating their patients. The American Cancer Society’s Cancer Action Network says under current procedure, more than 4500 North Dakotans who will be diagnosed with cancer in 2025, have to wait for prior authorization before treatment can begin.
"Time was, 20 or 30 years ago, prior authorization was typically needed for more specific elaborate surgeries, to make double-dog sure that was exactly what was needed, because it could be expensive or life-changing," said Cancer Action Network North Dakota Government Relations Director Ben Hanson. He said now, prior authorization has become routine for virtually everything, even all the way down to renewing prescription drugs.
"Just seems kinda silly," Hanson said.
Hanson said what this bill does is say to the carriers is that they need to have a specific turn-around time — such as 72 hours, in the case of emergency and seven calendar days in a non-emergency — just to hear if someone is approved or disapproved.
"It's not saying they have to be approved," Hanson said. "It's saying you have to communicate in a timely manner."
Hanson also said the approvals could be done by anyone the carrier would like.
"But if it's a denial, we want that denial to be done by someone who is in a like medical field," Hanson said.
The Cancer Action Network says 23 states have passed more than 43 bills in the past few years — 18 in 2024 alone.
