[{"_1":2,"_100":-5,"_101":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6342413,"mediaKeyId","2254757-abd427fc4b669fb891d18815d07b4d43","parentId",2254757,"title","Dentists and insurance department discuss in‑network denials and billing language in proposed dental amendments","audioSeconds",690,"startMs",4923000,"endMs",5613000,"viewUrl","/Search/View?dp=1&key=2254757-abd427fc4b669fb891d18815d07b4d43&start=4923&end=5613","thumbnailUrl","https://assets.pipeline.soar.com/2254757-abd427fc4b669fb891d18815d07b4d43/thumbnail_4923000.jpg","articleUrl","/articles/6342413/North-Dakota/Dentists-and-insurance-department-discuss-innetwork-denials-and-billing-language-in-proposed-dental-amendments","mediaUrl","https://secure.pipeline.soar.com/6342413-6579e5f8bcc910261288e7f1f84d1b27/orig.mp4?Expires=1771182531&Signature=Q3igCfJMs3NhLC9c1gXp1GQeeMjXA6BzSSmjWp6LMKTmXyrpZ2WLXK-pKfj2R0YjCrBzSv4bd0X6OzumRYHp3ofY7cUGoMe2RMAAnqi-rDAKMdsYqf2X5GGrGi5DV4-8EnpUH6nUxH59taJLNGTqB04pwIzGqfIZpODckNEVmshB05PHoxIvm5erT1j8UaC9ekq3SfPfY35Rq3wP9JR-pGcGN4KjaHaVrBTMr1I4DlOt4Mf~5~RI90mB5h1PXz05YS~TTygLxaXpEsPI516qd~PM9u4ptseG5609K3LIpTBaxnrXjhNn2ladjkKeIq3xRjuVUEuxqKeSctyxUw03aw__&Key-Pair-Id=KUT5TJCACFTXG","author","North Dakota State Legislature","date","2025-02-10T00:00:00Z","article","Representatives of the North Dakota Dental Association and the state Insurance Department discussed proposed amendments Oct. 12 to bills addressing insurer–provider contract language and a dentist’s ability to collect payment when an insurer denies payment.

William Sherwin of the North Dakota Dental Association told the Senate Human Services Committee that carriers have been denying coverage and also using contract provisions that prevent dentists from billing patients for services the carrier declines to cover. Sherwin urged language that would prevent an in‑network preferred provider arrangement from both denying a covered service and contractually prohibiting the dental provider from collecting payment from the patient.

Sherwin described the problem using typical dental examples: differences between a bridge and an implant, or materials choices, and frequency limits like a third cleaning that insurers will deny under annual or lifetime limits. He said the association wants to preserve a patient's ability to elect and pay for care when a carrier will not reimburse it, while also recognizing the committee must guard against abusive billing.

Crystal Bartuska of the North Dakota Insurance Department told the committee she had just received the draft amendments and needed time to review them with staff. Bartuska said the department’s priority is consumer protection and that she was concerned the amendment could be read to authorize dentists to obtain higher payment or balance‑bill consumers beyond in‑network schedules; she asked for time to work with the dental association to ensure the bill does not produce unintended consumer harms.

Sherwin said the dental association supports consumer protections such as the state’s balance‑billing statute (cited by committee staff as a prior measure in 21‑35) but still wants guardrails so a patient who chooses additional or elective treatment may arrange payment with their dentist when the carrier will not pay. The committee and staff agreed to confer further with the Insurance Department on precise wording to ensure the amendment preserves patient choice without enabling overbilling.

No vote was taken on the dental amendment during the hearing; the committee asked the Insurance Department and the dental association to confer and return with a clarified amendment.","mediaType","Video","parentTitle","Senate Human Services Mon, Feb 10, 2025 ","oneSentenceSummary","The North Dakota Dental Association urged changes to in‑network contract language to prevent insurers from both denying coverage and preventing providers from collecting payment; the Insurance Department asked for more time to study balance-billing risks and enforcement implications.","taxTitle","Human Services, Senate, Legislative, North Dakota","taxId",28905,"location","North Dakota","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6342416,"Committee moves insulin cap pilot into PERS; amendment and referral pass unanimously",2738,2077000,4815000,"/Search/View?dp=1&key=2254757-abd427fc4b669fb891d18815d07b4d43&start=2077&end=4815","https://assets.pipeline.soar.com/2254757-abd427fc4b669fb891d18815d07b4d43/thumbnail_2077000.jpg","/articles/6342416/North-Dakota/Committee-moves-insulin-cap-pilot-into-PERS-amendment-and-referral-pass-unanimously","https://secure.pipeline.soar.com/6342416-e0595f1c50212272850d5f1f4cfddb16/orig.mp4?Expires=1771182531&Signature=RQTVCyhSwuHAv5PlZkFsRdwrIDqVIedENjJ8n2aAGcn5pSLI5T1bDubvt6NvPqrpQA1H~AnHiTCK8HTkVvW5kNjyRO0GIMxtrAqGZpFMSjB-uYoTH4t8J10GNFN~ezFQiw6Fm35Ku4OjNisChDJxRxVYi4H8sE2tocjtgdmtpT1jNVpqV1bMQds6~0~S7Rd3wfykkGk9NMrmmwLcqPEji5seWTfRXp~IaOcRVWzjUsjXhveNKr7nXYGbtcq3kbHQSBfn6Wgx5F0DgLeHtbwar5IUgHGN1xpTfhs6ENfx8qZ7vhWKzZjIc045ItSsuM-XgxN-Hi7OX-XbxNNakuAk4g__&Key-Pair-Id=KUT5TJCACFTXG","The Senate Human Services Committee on Oct. 12 amended a bill addressing insulin cost caps to move the pilot project into the Public Employees Retirement System (PERS) statute and then voted to do pass as amended and re‑refer the bill to the next committee.

Senator Rohrs moved the amendment to place the insulin pilot in the PERS code, remove the remainder of the insurance-market language from the Senate draft, and keep PERS coverage for insulin supplies; Senator Hogan seconded. Rebecca Fricke, executive director of PERS, told the committee the fiscal note attached to the bill applies to PERS and estimated the state cost at just under $834,000 and described the employer-share impact as about 12% of premium.

Committee members discussed two parallel vehicles: the Senate draft (referred to in committee as 23-70) and an identical House measure (House Bill 11-14) that had passed its committee. Fricke and other stakeholders said keeping the coverage for PERS members was the committee’s immediate priority. Senator Clemens said she would not support a mandate that applied to the commercial insurance market and supported restricting the change to PERS.

After discussion, the committee voted on the amendment. The roll call recorded the following votes on the amendment: Senator Lee — Aye; Senator Weston — Aye; Senator Rohrs — Aye; Senator Hogan — Aye; Senator Van Osteen — Aye; Senator Clemens — Aye. The amendment passed. The committee then voted to do pass as amended and re‑refer the bill; the roll call on that motion recorded the same Aye votes. Senator Rohrs volunteered to carry the bill.

Committee members and PERS staff discussed options for making the pilot permanent in PERS code rather than leaving it in the insurance-code pilot language. Fricke said the proposal would be similar to prior PERS-specific statutory additions (for example, prosthetic limb coverage enacted previously) and could be accommodated using language from last session’s SB 2140 that placed related coverage under PERS code (54-52.1). The committee asked Legislative Council and PERS staff to prepare the wording of the amendment. Victoria Christian of Legislative Council noted there is no appropriation in the bill itself but the fiscal note will require re-referral to appropriations.

The committee’s action keeps the insulin-cap coverage available to the PERS population while avoiding a broader commercial-market insurance mandate in this Senate vehicle. The committee referred the amended bill to the next committee and recorded the fiscal-note estimate for the state share of roughly $834,000.","The Senate Human Services Committee amended SB 23-70 to place an insulin cost-cap pilot permanently in the Public Employees Retirement System (PERS) statute and voted to re-refer the bill; committee members said the change preserves coverage for state employees while avoiding a commercial-market insurance mandate.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6342422,"Senate committee reviews broad rewrite of guardianship and health-care agent language in SB 2297",3073,727000,3800000,"/Search/View?dp=1&key=2254757-abd427fc4b669fb891d18815d07b4d43&start=727&end=3800","https://assets.pipeline.soar.com/2254757-abd427fc4b669fb891d18815d07b4d43/thumbnail_727000.jpg","/articles/6342422/North-Dakota/Senate-committee-reviews-broad-rewrite-of-guardianship-and-health-care-agent-language-in-SB-2297","https://secure.pipeline.soar.com/6342422-c2de041292c95c6fe35a96497c5f9ce3/orig.mp4?Expires=1771182531&Signature=cz72tSw0OyE4DvyrEKhbsdl4gCSGOfpd0HT4TZ-TjbuR3VqCXf7ciqQhAaUBcTWg173gwUExFMPD~OA-y-bRGTUwTc34pz~py-Rfo6kMmaVJ5~VexNkvP-kYfR9DMBDffx4UaIk1S7sVKApZclA~PgN0CPmVd7Df8nt6M2lEbstmleQV-4EghZ3llwEdckkOmL0ijm~IhpL3wMLRT-PQQJQ0h9O88jLsDizYP3yOZyNKUipzA4kPOPIQdBlXCB996UP2U~hqIKBT9sKkYR53zjn3L~FYTLwH09m0t2sGEKME1lyEXUial7Hx10qWkplYOdVIv9baI91x1S0FIwr2rA__&Key-Pair-Id=KUT5TJCACFTXG","The Senate Human Services Committee on Oct. 12 reviewed a near-complete rewrite of Senate Bill 2297 intended to clarify the order of decisionmakers when a patient lacks capacity and to use health-care directive definitions instead of probate definitions.

Christopher Dodson, legal counsel for the North Dakota Catholic Conference, told the committee he started at the top of the section because small edits to one sentence created cascading problems. Dodson said the draft replaces probate-code definitions of incapacity with the definition used in the health-care-directive statute and reorganizes the order of priority for decisionmakers so the text is clearer.

The rewrite, Dodson said, retains existing substance but “cleaned up a lot of stuff” so sentences read consistently and decisionmakers are listed at the start of subsections. He told the panel the intention of current law is that a guardian who is expressly authorized by court order to override a patient’s appointed health-care agent is the first priority, then the health-care agent, then other guardians or custodians — and that his redraft tries to reflect that intent.

The change replaces a probate-code definition of incapacity with language from the health-care-directive chapter. Dodson quoted the directive-style definition in committee: a patient who is \"not able to understand and appreciate the nature and consequences of a health-care decision including the significant benefits and harms of any reasonable alternatives\" and whose incapacity is certified in writing by the attending physician and placed in the medical record.

Committee members pressed on how the draft treats minors versus incapacitated adults. Several senators — including Senator Clemens and Senator Weston — said parents should be explicit in the hierarchy for minors, and asked whether the draft should separate minors into a different subsection. Victoria Christian of Legislative Council told the committee the draft intentionally defines “incapacitated patient” to include a minor for the purposes of this section so the section can operate by a single definition, and that the classification would not remove parents’ rights where those apply.

Republican and Democratic senators also asked about the size of an interim interdisciplinary team the bill authorizes to act when immediate decisions are needed. Marnie Waltz of Sanford Health and Melissa from the hospital association (both participating in drafting) told the committee that hospital ethics/clinical teams prefer three-person panels in some circumstances but that rural critical-access hospitals may not always have three clinicians available; the committee discussed allowing nonphysician members (for example, a nurse, spiritual-care staff or legal counsel) to meet a three-person requirement.

Legislative Council staff and the drafter agreed to produce a clean LC amendment to reflect the committee’s questions, including clearer treatment of minors and the guardian/agent priority questions Dodson raised. Victoria Christian told the committee she could prepare either separate subsections for minors and incapacitated adults, or keep a single section with two subsections for clarity; staff recommended language additions to explicitly preserve parental decision authority where applicable.

The committee did not take a formal vote on SB 2297. Members directed Legislative Council to draft an amendment that addresses the committee’s concerns and to coordinate further with Mr. Dodson and hospital stakeholders; committee members deferred further action until they have Legislative Council’s amended language.

The discussion also identified several discrete drafting issues the committee asked staff to resolve before any vote: whether to treat minors as a separate subsection, where to place parents in the order of priority, whether a “guardian with health-care authority” should automatically defer to an existing health-care agent unless a court order says otherwise, and whether an interdisciplinary team should require two or three members.

Victoria Christian told the committee the item does not need to be passed out today and Legislative Council will produce a draft amendment for the committee to review.

The committee's conversation was largely procedural and technical; there were no formal motions or votes recorded on the bill during the hearing.","The Senate Human Services Committee discussed a large redraft of Senate Bill 2297 intended to clarify when guardians, health-care agents and family members may provide informed consent; Legislative Council will prepare a clean amendment after committee direction.","actionData","errors"]

Article not found

Dentists and insurance department discuss in‑network denials and billing language in proposed dental amendments

Committee moves insulin cap pilot into PERS; amendment and referral pass unanimously

Senate committee reviews broad rewrite of guardianship and health-care agent language in SB 2297