BISMARCK, N.D. –– North Dakota legislators have strong momentum against cancer heading into the second half of the session as bills on prior authorization reform, supplemental breast cancer detection screenings and co-pay accumulator adjustments are progressing. Advocates of the American Cancer Society Cancer Action Network are grateful for the progress that’s been made so far, having visited with lawmakers earlier in the session, and now urge them to finish the job and pass all three before business adjourns.
The legislation is as follows:
Prior authorization reform: For the more than 4,500 North Dakotans who will be diagnosed with cancer in 2025, medical prior authorization can delay treatment, increase stress and have a negative impact on care. Senate Bill 2280 would establish standards and transparency to prior authorization processes, helping those in need of critical medical care avoid prolonged delays in treatment.
Physicians report the process can lead to significant delays in care, contributing to negative outcomes in patients, including abandoned treatment. The process was once used sparingly by insurers to determine whether costly medical procedures or medications were needed but has devolved into a system requiring providers get approval to prescribe even the most routine medications and procedures. The bill’s primary sponsors are Sens. Scott Meyer (Grand Forks) with Jeff Barta (Grand Forks), Brad Bekkedahl (Williston) and Sean Cleary (Bismarck) co-sponsoring in the Senate and Jonathan Warrey (Casselton) and Jon Nelson (Rugby) in the House.
“Cancer patients should not have to wait out bureaucratic delays that can have a negative impact on their care,” ACS CAN North Dakota Government Relations Director Ben Hanson said. “There’s a clear need for this legislation and the hope is House members will see the benefit it would bring to thousands.”
Supplemental breast cancer detection screenings: House Bill 1283 would require all state-regulated health policies to eliminate patient out-of-pocket costs for medically necessary diagnostic and supplemental breast imaging. It would require breast diagnostic mammograms (x-rays), breast ultrasounds, and breast magnetic resonance imaging (MRI) scans be covered by insurers at no-cost-share when deemed medically necessary by their physician. It would allow North Dakotans to complete the full continuum of breast cancer screening without having to make excruciating financial choices about basic daily needs over their long-term health.
“North Dakota patients should not face large out-of-pocket costs to detect breast cancer early,” said Rep. Karen Karls, who is sponsoring the bill. “Early detection saves lives and money and other states that have done this, like Montana, have found that the finances make sense.”
Co-pay accumulators: Also sponsored by Karls, House Bill 1216 would require all prescription drug copayments made by patients, directly or on their behalf, to count toward their overall out-of-pocket maximum or deductible, making cancer treatment more affordable and saving some North Dakotans from additional medical debt. A 2022 ACS CAN study found 31% of cancer patients and providers noted paying for prescriptions as a challenge and 20% indicated that financial considerations had caused them to skip or delay taking prescribed medication.
“We need insurers to count copay assistance paid by or on behalf of an enrollee toward their annual deductibles and out-of-pocket limit to allow North Dakotas life-saving drugs,” Karls said. “This bill would be a step toward easing that problem.”
ACS CAN encourages individuals, businesses and organizations that are interested in getting involved in the fight against cancer to visit https://www.fightcancer.org/states/north-dakota
