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North Dakota House Bill HB1248

North Dakota 2025-2026 Regular Session

North Dakota House Bill HB1248 Compare Versions

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1-25.0740.05000
1+25.0740.02002
2+Title.04000
3+Adopted by the Senate Human Services
4+Committee
25 Sixty-ninth
6+March 20, 2025
37 Legislative Assembly
48 of North Dakota
59 Introduced by
610 Representatives Weisz, Frelich, McLeod, M. Ruby
711 Senators Lee, Dever
8-A BILL for an Act to amend and reenact section 54-03-28 of the North Dakota Century Code,
9-relating to the cost-benefit analysis requirement for health insurance mandated coverage of
10-services.
12+A BILL for an Act to amend and reenact sections 26.1-36-09.12 and 54-35-02.4 of the North
13+Dakota Century Code, relating to medical services related to suicide and the powers and duties
14+of the employee benefits programs committee; and to repeal section 54-03-28 of the North
15+Dakota Century Code, relating to the cost-benefit analysis requirement for health insurance
16+mandated coverage of services.for an Act to amend and reenact section 54-03-28 of the North
17+Dakota Century Code, relating to the cost-benefit analysis requirement for health insurance
18+mandated coverage of services.
1119 BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
12-SECTION 1. AMENDMENT. Section 54-03-28 of the North Dakota Century Code is
20+ SECTION 1. AMENDMENT. Section 26.1-36-09.12 of the North Dakota Century Code is
1321 amended and reenacted as follows:
14-54-03-28. Health insurance mandated coverage of services - Cost-benefit analysis
15-requirement.
16-1.If the legislative management determines a legislative measure mandates health
17-insurance coverage of services or payment for specified providers of services, the
18-measure may not be referred to a committee of the legislative assembly unless a
19-cost-benefit analysis provided by the legislative management is appended to that
20-measure.
21-a.If a committee of the legislative assembly determines a measure mandating
22-health insurance coverage of services or payment of specified providers was
23-referred to committee without a cost-benefit analysis, the committee shall request
24-the legislative management provide a cost-benefit analysis. The committee may
25-not act on the measure unless the measure is accompanied by the cost-benefit
26-analysis.
27-b.If a committee of the legislative assembly determines a proposed amendment to
28-a measure mandates health insurance coverage of services or payment of
29-specified providers, the committee may not act on the proposed amendment
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22+ 26.1-36-09.12. Medical services related to suicide.
23+ An insurance company, nonprofit health service corporation, or health maintenance
24+organization may not deliver, issue, execute, or renew anya hospital, surgical, medical, or major
25+medical benefit policy on an individual, group, blanket, franchise, or association basis unless
26+the policy, contract, or evidence of coverage provides benefits, of the same type offered under
27+the policy or contract for illnesses, for health services to any individual covered under the policy
28+or contract for injury or illness resulting from suicide, attempted suicide, or self-inflicted injury.
29+The medical benefits provided for in this section are exempt from section 54-03-28.
30+SECTION 2. AMENDMENT. Section 54-35-02.4 of the North Dakota Century Code is
31+amended and reenacted as follows:
32+Page No. 1 25.0740.02002
3133 ENGROSSED HOUSE BILL NO. 1248
3234 FIRST ENGROSSMENT
33-with Conference Committee Amendments
35+PROPOSED AMENDMENTS TO
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57-unless the amendment is accompanied by a cost-benefit analysis or amended
58-cost-benefit analysis provided by the legislative management.
59-2.Factors considered in the cost-benefit analysis must include:
60-a.The extent to which the proposed mandate would increase or decrease the cost
61-of the service.
62-b.The extent to which the proposed mandate would increase the appropriate use of
63-the service.
64-c.The extent to which the proposed mandate would increase or decrease the
65-administrative expenses of insurers and the premium and administrative
66-expenses of insureds.
67-d.The impact of the proposed mandate on the total cost of health care.
68-3.AThe legislative management shall adopt a procedure for identifying measures and
69-proposed measures mandating health insurance coverage of services or payment for
70-specified providers of services. The procedure must include solicitation of draft
71-measures and proposals during the interim between legislative sessions from
72-legislators and agencies with bill introduction privileges and must include deadlines for
73-identification of the measures or proposals.
74-2.Except as provided in subsection 3, a committee of the legislative assembly may not
75-act on a legislative measure that the legislative management or committee determines
76-mandates health insurance coverage of services or payment for specified providers of
77-services unless the measure as recommended by the committee provides:
78-a.The measure is effective through June thirtieth of the next odd-numbered year
79-following the year in which the legislative assembly enacted the measure, and
80-after that date the measure is ineffective.
81-b.The application of the mandate is limited to the public employees health
82-insurance program and the public employee retiree health insurance program.
83-The application of suchthe mandate begins with every contract for health
84-insurance which becomes effective after June thirtieth of the year in which the
85-measure becomes effective.
86-c.That for the next legislative assembly, the public employees retirement system
87-shall prepare and request introduction of a bill to repeal the expiration date and to
88-Page No. 2 25.0740.05000
57+ 54-35-02.4. Employee benefits programs committee - Powers and duties.
58+ 1. During each interim, the employee benefits programs committee shall consider:
59+ a. Consider and report on the legislative proposals over which the committee takes
60+jurisdiction and which fiscally impact the retirement programs of state employees
61+or employees of any political subdivision, and health and retiree health plans of
62+state employees or employees of any political subdivision. A majority of the
63+members of the committee has sole authority to determine whether a legislative
64+proposal affects a program. The committee shall make
65+ b. Make a thorough review of each proposal the committee takes under its
66+jurisdiction, including an actuarial report. The committee shall take
67+ c. Take jurisdiction over a proposal that authorizes an automatic increase or other
68+change in benefits beyond the ensuing biennium which would not require
69+legislative approval. The committee shall include
70+ d. Include in the report of the committee a statement that the proposal would allow
71+future changes without legislative involvement. The committee shall report
72+ e. Report the findings and recommendations of the committee, along with any
73+necessary legislation, to the legislative management and to the legislative
74+assembly.
75+ 2. To carry out the responsibilities of the committee, the committee, or the designee of
76+the committee, may:
77+ a. Enter contracts, including retainer agreements, with an actuary or actuarial firm
78+for expert assistance and consultation. Each retirement, insurance, or retiree
79+insurance program shall pay, from the program's retirement, insurance, or retiree
80+health benefits fund, as appropriate, and without the need for a prior
81+appropriation, the cost of an actuarial report required under this section which
82+relates to that program.
83+ b. Call on personnel from state agencies or political subdivisions to furnish such
84+information and render such assistance as the committee from time to time may
85+request.
86+ c. Establish rules for the operation of the committee, including the submission and
87+review of proposals and the establishing of standards for actuarial reports.
88+Page No. 2 25.0740.02002
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121-extend the mandated coverage or payment to apply to accident and health
122-insurance policies. The public employees retirement system shall append to the
123-billprovide to the employee benefits programs committee a report regarding the
124-effect of the mandated coverage or payment on the system's health insurance
125-programs. The report must include information on the utilization and costs
126-relating to the mandated coverage or payment and a recommendation on
127-whether the coverage or payment should continue for the system's health
128-insurance programs. For purposes of this section, the bill is not a legislative
129-measure mandating health insurance coverage of services or payment for
130-specified providers of services, unless the bill is amended following introduction
131-so as to change the bill's mandate.
132-4.The legislative management shall adopt a procedure for identifying measures and
133-proposed measures mandating health insurance coverage of services or payment for
134-specified providers of services. The procedure must include solicitation of draft
135-measures and proposals during the interim between legislative sessions from
136-legislators and agencies with bill introduction privileges and must include deadlines for
137-identification of the measures or proposals.
138-3.If the legislative management determines a legislative measure mandating health
139-insurance coverage of services or payment for specified providers of services has
140-completed the process under subsection 2, the measure may not be referred to a
141-committee of the legislative assembly unless a cost-benefit analysis provided by the
142-legislative management is appended to the measure.
143-a.If a committee of the legislative assembly determines a measure or a proposed
144-amendment to the measure mandating health insurance coverage of services or
145-payment of specified providers of services was referred to committee without a
146-cost-benefit analysis, the committee shall request the legislative management
147-provide a cost-benefit analysis.
148-b.The committee may not act on the measure unless the measure is accompanied
149-by the cost-benefit analysis.
150-4.Factors considered in the cost-benefit analysis must include:
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121+ 3. The committee may solicit draft measures and proposals from interested persons
122+during the interim between legislative sessions, and also may study measures and
123+proposals referred to the committee by the legislative assembly or the legislative
124+management.
125+ 4. A copy of the committee's report concerning a legislative measure, if that measure is
126+introduced for consideration by a legislative assembly, must be appended to the copy
127+of that measure.
128+ 5. If a legislative measure affecting a public employees retirement program, public
129+employees health insurance program, or public employee retiree health insurance
130+program is introduced in either house without a report from the committee, the
131+chairman and vice chairman of the employee benefits programs committee shall
132+request an actuarial report from the program affected and shall provide the report to
133+the standing committee to which the measure is referred. During the legislative
134+session, the employee benefits programs committee chairman and vice chairman,
135+working together, have sole authority to determine whether a legislative measure or
136+amendment affects a program under this subsection and subsection 6.
137+ 6. During a legislative session, if an amendment is made to a legislative measure which
138+fiscally impacts a public employees retirement program, public employees health
139+insurance program, or public employee retiree health insurance program, the
140+employee benefits programs committee chairman and vice chairman shall request
141+from the affected program an actuarial report on the amendment and shall provide the
142+report to the standing committee to which the bill is referred.
143+ 7. A committee of the legislative assembly may not act on a legislative measure the
144+legislative management or committee determines mandates health insurance
145+coverage of services or payment for specified providers of services for the health and
146+retiree health plans of state employees or employees of any political subdivision
147+unless the measure as recommended by the committee provides:
148+ a. The measure is effective through June thirtieth of the second odd - numbered year
149+following the year in which the legislative assembly enacted the measure, and
150+after that date the measure is ineffective.
151+Page No. 3 25.0740.02002
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181181 30 Sixty-ninth
182182 Legislative Assembly
183-a.The extent to which the proposed mandate would increase or decrease the cost
184-of the service.
185-b.The extent to which the proposed mandate would increase the appropriate use of
186-the service.
187-c.The extent to which the proposed mandate would increase or decrease the
188-administrative expenses of insurers and the premium and administrative
189-expenses of insureds.
190-d.The impact of the proposed mandate on the total cost of health care.
191-5.The legislative council shall contract with a private entity, after receiving one or more
192-recommendations from the insurance commissioner, to provide the legislative
193-management the cost-benefit analysis required by this section. The insurance
194-commissioner shall pay the cost of the contracted services to the entity providing the
195-services.
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183+ b. The application of the mandate begins with the contract for health insurance
184+which becomes effective after June thirtieth of the year in which the measure
185+becomes effective.
186+ c. For the second legislative assembly following the year in which the legislative
187+assembly enacted the measure, the public employees retirement system may
188+prepare and request introduction of a bill to repeal the expiration date and to
189+extend the mandated coverage or payment on the system's health insurance
190+programs.
191+ d. If the public employees retirement system introduces a bill to repeal the
192+expiration date under subdivision c, the public employees retirement system shall
193+append to the bill a report regarding the effect of the mandated coverage or
194+payment on the system's health insurance programs. The report must include
195+information on the utilization and costs relating to the mandated coverage or
196+payment.
197+ 8. Legislation enacted in contravention of this section is invalid, and any benefits
198+provided under the legislation must be reduced to the level current before enactment
199+of the legislation.
200+ SECTION 3. REPEAL. Section 54-03-28 of the North Dakota Century Code is repealed.
201+SECTION 1. AMENDMENT. Section 54-03-28 of the North Dakota Century Code is
202+amended and reenacted as follows:
203+54-03-28. Health insurance mandated coverage of services - Cost-benefit analysis
204+requirement.
205+1.If the legislative management determines a legislative measure mandates health
206+insurance coverage of services or payment for specified providers of services, the
207+measure may not be referred to a committee of the legislative assembly unless a
208+cost-benefit analysis provided by the legislative management is appended to that
209+measure.
210+a.If a committee of the legislative assembly determines a measure mandating
211+health insurance coverage of services or payment of specified providers was
212+referred to committee without a cost-benefit analysis, the committee shall request
213+the legislative management provide a cost-benefit analysis. The committee may
214+Page No. 4 25.0740.02002
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247+not act on the measure unless the measure is accompanied by the cost-benefit
248+analysis.
249+b.If a committee of the legislative assembly determines a proposed amendment to
250+a measure mandates health insurance coverage of services or payment of
251+specified providers, the committee may not act on the proposed amendment
252+unless the amendment is accompanied by a cost-benefit analysis or amended
253+cost-benefit analysis provided by the legislative management.
254+2.Factors considered in the cost-benefit analysis must include:
255+a.The extent to which the proposed mandate would increase or decrease the cost
256+of the service.
257+b.The extent to which the proposed mandate would increase the appropriate use of
258+the service.
259+c.The extent to which the proposed mandate would increase or decrease the
260+administrative expenses of insurers and the premium and administrative
261+expenses of insureds.
262+d.The impact of the proposed mandate on the total cost of health care.
263+3.A committee of the legislative assembly may not act on a legislative measure that the
264+legislative management or committee determines mandates health insurance
265+coverage of services or payment for specified providers of services unless the
266+measure as recommended by the committee provides:
267+a.The measure is effective through June thirtieth of the next odd-numbered year
268+following the year in which the legislative assembly enacted the measure, and
269+after that date the measure is ineffective.
270+b.The application of the mandate is limited to the public employees health
271+insurance program and the public employee retiree health insurance program.
272+The application of such mandate begins with every contract for health insurance
273+which becomes effective after June thirtieth of the year in which the measure
274+becomes effective.
275+ c. That for the next legislative assembly, the public employees retirement system
276+shall prepare and request introduction of a bill to repeal the expiration date and to
277+Page No. 5 25.0740.02002
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309+extend the mandated coverage or payment to apply to accident and health
310+insurance policies. The
311+ 4. At the conclusion of the process in this section, the public employees retirement
312+system shall append to the billsubmit a report regarding the effect of the mandated
313+coverage or payment on the system's health insurance programs. The report must
314+include information on the utilization and costs relating to the mandated coverage or
315+payment and a recommendation on whether the coverage or payment should
316+continue. For purposes of this section, the bill is not a legislative measure mandating
317+health insurance coverage of services or payment for specified providers of services,
318+unless the bill is amended following introduction so as to change the bill's mandate.
319+4.5.The legislative management shall adopt a procedure for identifying measures and
320+proposed measures mandating health insurance coverage of services or payment for
321+specified providers of services. The procedure must include solicitation of draft
322+measures and proposals during the interim between legislative sessions from
323+legislators and agencies with bill introduction privileges and must include deadlines for
324+identification of the measures or proposals.
325+5.6.The legislative council shall contract with a private entity, after receiving one or more
326+recommendations from the insurance commissioner, to provide the legislative
327+management the cost-benefit analysis required by this section. The insurance
328+commissioner shall pay the cost of the contracted services to the entity providing the
329+services at the conclusion of the process under subsection 3.
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