New North Dakota law to ease medical stress for patients

FARGO, N.D. (Valley News Live) – A new law signed by Governor Kelly Armstrong Wednesday is going to give patients an affordable way to get medical care faster.

The new law has to do with prior authorization reform. It means doctors must get approval from insurance companies before they move forward with care. Except, this new law will make that process faster.

“What this legislation does is it says if you’re in an emergency situation, the insurers have to get back to you for prior authorization within 72 hours. Or, a non-emergency case, within seven calendar days. That’s seven days, not including holidays, because things like cancer don’t take a vacation,” said Ben Hanson, the ND government relations director for the American Cancer Society Cancer Action Network.

It’s not just cancer patients who will benefit. Those at Essentia Health say getting the authorization quicker will make a world of difference.

“We have a lot of patients who travel, you know, from sometimes rural settings or are planning to, you know, travel. They know they need service, whether it’s surgical or imaging, or medications,” Dr. Stefanie Gefroh, West Market president and in the gynecology department at Essentia says.

Those at Altru say it means these inquiries will go to the right specialists. Courtney McNamee, Director of Payer Revenue Management and Patient Services, shares one example of how delayed prior authorization could impact patients.

“In March, we had submitted a request for an authorization for a patient for a back surgery. We went through three different appeal processes. Finally, at the end of July, the patient received the authorization to receive the care.”

This is only the beginning.

“The next step is making sure the prior authorizations are honored,” added Dr. Gefroh.

“The insurance company may change some aspects. So that’s probably the next piece of oversight that our team will work with others.”

Hanson adds: “There’s absolutely no point in having a cancer patient that’s been approved for prior authorization approval, for chemotherapy to go and prove they have cancer again because their employer changed insurance providers. That’s a great super protection policy.”

Those with the American Cancer Society’s Cancer Action Network say more than 4,500 North Dakotans will be diagnosed with cancer this year.

Sanford Health issued the following statement to Valley News Live:

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