North Dakota 2025-2026 Regular Session

North Dakota Senate Bill SB2375 Compare Versions

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1		-	Sixty-ninth Legislative Assembly of North Dakota
2		-	In Regular Session Commencing Tuesday, January 7, 2025
3		-	SENATE BILL NO. 2375
4		-	(Senators Castaneda, Bekkedahl, Lee, Barta)
5		-	(Representatives Vigesaa, Ostlie)
6		-	AN ACT to create and enact a new section to chapter 43-28 of the North Dakota Century Code, relating
7		-	to joint negotiations by dental providers with dental insurers.
	1	+	25.1361.02005
	2	+	Title.03000
	3	+	Adopted by the House Industry,
	4	+	Business and Labor Committee
	5	+	Sixty-ninth
	6	+	March 25, 2025
	7	+	Legislative Assembly
	8	+	of North Dakota
	9	+	Introduced by
	10	+	Senators Castaneda, Bekkedahl, Lee, Barta
	11	+	Representatives Vigesaa, Ostlie
	12	+	A BILL for an Act to create and enact a new section to chapter 43-28 of the North Dakota
	13	+	Century Code, relating to joint negotiations by dental providers with dental insurers; to amend
	14	+	and reenact section 54-57-07 of the North Dakota Century Code, relating to compensation for
	15	+	the provision of administrative law judges; and to provide a penalty.for an Act to create and
	16	+	enact a new section to chapter 43-28 of the North Dakota Century Code, relating to joint
	17	+	negotiations by dental providers with dental insurers.
8	18		BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
9		-	SECTION 1. A new section to chapter 43-28 of the North Dakota Century Code is created and
10		-	enacted as follows:
	19	+	SECTION 1. A new section to chapter 43-28 of the North Dakota Century Code is created
	20	+	and enacted as follows:
	21	+	Joint negotiations by dental providers with dental insurers.
	22	+	1. As authorized under this section, two or more dental providers practicing in the service
	23	+	area of a dental insurer may jointly negotiate with the dental insurer and engage in
	24	+	related joint activity regarding non-fee-related matters including:
	25	+	a. Definition of medical necessity and other conditions of coverage.
	26	+	b. Utilization management criteria and procedures.
	27	+	c. Clinical practice guidelines.
	28	+	d. Preventative care and other medical management policies.
	29	+	e. Patient referral standards and procedures.
	30	+	f. Drug formularies and standards for prescribing off-formulary drugs.
	31	+	g. Quality assurance programs.
	32	+	Page No. 1 25.1361.02005
	33	+	ENGROSSED SENATE BILL NO. 2375
	34	+	FIRST ENGROSSMENT
	35	+	PROPOSED AMENDMENTS TO
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	57	+	h. Liability terms for a dental provider and dental insurer.
	58	+	i. Methods and timing of payments.
	59	+	j. Administrative procedures.
	60	+	k. Credentialing standards and procedures for selection, retention, and termination
	61	+	of participating dentists.
	62	+	l. Mechanisms for resolving disputes between the dental insurer and dental
	63	+	provider.
	64	+	m. Dental benefits sold or administered by the dental insurer in which the dental
	65	+	provider is required to participate.
	66	+	n. Formulation and application of reimbursement methodology.
	67	+	o. Inclusion or alteration of a contractual term or condition, except when the
	68	+	inclusion or alteration is otherwise required by federal or state law.
	69	+	2. As authorized under this section, upon a finding by the office of administrative
	70	+	hearings that a dental insurer has substantial market power in a service area and any
	71	+	of the terms or conditions of the contract with the dental insurer pose an actual or
	72	+	potential threat to the quality and availability of patient care among covered
	73	+	individuals, two or more independent dental providers may jointly negotiate with the
	74	+	dental insurer and engage in related joint activity relating to fees and fee-related
	75	+	matters, including the:
	76	+	a. Amount of payment.
	77	+	b. Amount of discount.
	78	+	c. Procedure codes or descriptions of services covered by payment.
	79	+	d. Appropriate grouping of procedure codes.
	80	+	3. a. The dental providers may communicate with each other and a joint negotiation
	81	+	representative authorized to negotiate on behalf of the dental providers with the
	82	+	dental insurer concerning any contractual term or condition to be negotiated. For
	83	+	purposes of this section, a "joint negotiation representative" means a
	84	+	representative selected by two or more independent dental providers to engage
	85	+	in joint negotiations with a dental insurer on behalf of the dental providers.
	86	+	b. The joint negotiation representative is the only party authorized to negotiate with
	87	+	the dental insurer on behalf of the dental providers as a group.
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	121	+	c. The dental providers may agree to be bound by the terms and conditions
	122	+	negotiated by the joint negotiation representative.
	123	+	4. A person may not act as a joint negotiation representative without express permission
	124	+	from the office of administrative hearings.
	125	+	5. Upon the joint negotiation representative and dental insurer determining an agreement
	126	+	has been reached on contractual terms or conditions that will be the subject matter of
	127	+	the negotiations, the joint negotiation representative shall submit to the office of
	128	+	administrative hearings, for approval, a copy of the proposed contract between the
	129	+	dental providers and dental insurer.
	130	+	a. Within thirty days of receipt of the proposed contract, the office of administrative
	131	+	hearings shall review the proposed contract and provide a determination. If the
	132	+	office of administrative hearings disapproves the contract, the office of
	133	+	administrative hearings shall communicate to the joint negotiation representative
	134	+	any deficiencies and specific remedial measures for the deficiencies.
	135	+	b. Upon approval of the proposed contract, the dental providers, through the joint
	136	+	negotiation representative, and the dental insurer may engage in negotiations.
	137	+	c. The joint negotiation representative shall submit the negotiated contract to the
	138	+	office of administrative hearings for review.
	139	+	6. A negotiated contract and any plan of action for implementing a negotiated contract
	140	+	must be approved by the office of administrative hearings before becoming effective.
	141	+	Within thirty days of receipt of the negotiated contract, the office of administrative
	142	+	hearings shall review the proposed contract and provide a determination. If the office
	143	+	of administrative hearings disapproves the contract, the office of administrative
	144	+	hearings shall communicate to the joint negotiation representative any deficiencies
	145	+	and specific remedial measures for the deficiencies.
	146	+	7. The office of administrative hearings shall adopt rules and procedures as necessary to
	147	+	carry out the responsibilities of this section.
	148	+	8. This section does not apply to dental benefit plans providing covered services
	149	+	exclusively or primarily to individuals who are eligible for medical assistance.
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	181	+	9. Any negotiations under this section must be made in good faith. A person that does
	182	+	not negotiate in good faith may be subject to sanctions or penalties as determined by
	183	+	the office of administrative hearings.
	184	+	10. This section may not be construed to:
	185	+	a. Permit a coordinated cessation reduction or limitation of dental services.
	186	+	b. Affect governmental approval of, or otherwise restrict activity by, dental providers
	187	+	which is not prohibited under federal antitrust law or require approval of contract
	188	+	terms to the extent the terms are exempt from state regulation under federal law.
	189	+	11. The dental insurer is responsible for costs for services rendered by the office of
	190	+	administrative hearings and shall make payment for costs for services in accordance
	191	+	with section 54 - 57 - 07 and rules adopted by the office of administrative hearings.
	192	+	SECTION 2. AMENDMENT. Section 54-57-07 of the North Dakota Century Code is
	193	+	amended and reenacted as follows:
	194	+	54-57-07. Compensation for provision of administrative law judges - Special fund
	195	+	established - Continuing appropriation.
	196	+	1. The office of administrative hearings shall require payment for services rendered by
	197	+	any administrative law judge provided by it to anyan agency, to any unit of local
	198	+	government in this state, to any tribal government in this state, or to the judicial
	199	+	branch, or a nongovernmental entity, in the conduct of an administrative hearing and
	200	+	related proceedings, and proceedings under section 1 of this Act, and those entities
	201	+	must make the required payment to the office. Payment must include payment for
	202	+	support staff necessary to render administrative law judge services. Moneys received
	203	+	by the office of administrative hearings in payment for providing an administrative law
	204	+	judge to conduct an administrative hearing and related proceedings, and proceedings
	205	+	under section 1 of this Act, must be deposited into the operating fund of the office of
	206	+	administrative hearings.
	207	+	2. The office of administrative hearings shall require payment for mileage, meals, and
	208	+	lodging in connection with services rendered by an administrative law judge provided
	209	+	to anyan agency, to any unit of local government in this state, to any tribal government
	210	+	in this state, or to the judicial branch, or a nongovernmental entity, in the conduct of an
	211	+	administrative hearing and related proceedings, and proceedings under section 1 of
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	245	+	this Act, and those entities must make the required payment to the office. Payment for
	246	+	meals and lodging must be in the amounts allowable under section 44-08-04. Payment
	247	+	for mileage when using state vehicles must be in amounts set for user charges under
	248	+	section 24-02-03.5. All other payments must be in amounts allowed for other state
	249	+	officials and employees. Either general fund or special fund moneys, or other income,
	250	+	may be used for the payment of mileage, meals, and lodging under this subsection.
	251	+	3. A special fund is established in the state treasury and designated as the administrative
	252	+	hearings fund. The office of administrative hearings shall deposit in the fund all
	253	+	moneys received by it in payment for providing services rendered by any
	254	+	administrative law judge in the conduct of an administrative hearing and related
	255	+	proceedings, and proceedings under section 1 of this Act, under this chapter, as well
	256	+	as all moneys received by the office in payment for mileage, meals, and lodging in
	257	+	connection with providing any administrative law judge to conduct an administrative
	258	+	hearing and related proceedings, and proceedings under section 1 of this Act . The
	259	+	moneys in the fund are a standing and continuing appropriation and are appropriated,
	260	+	as necessary, for the following purposes:
	261	+	a. For the office of administrative hearings to pay for salaries, wages, benefits,
	262	+	operating expenses, and equipment, including payment to temporary
	263	+	administrative law judges, as necessary, for the purpose of providing requested
	264	+	administrative law judges to agenciesan agency, to any unit of local government
	265	+	in this state, to any tribal government in this state, or to the judicial branch, or a
	266	+	nongovernmental entity .
	267	+	b. For the office of administrative hearings to pay mileage, meals, and lodging to
	268	+	any administrative law judges, as necessary, in connection with the services to be
	269	+	provided under this chapter.
	270	+	SECTION 1. A new section to chapter 43-28 of the North Dakota Century Code is created
	271	+	and enacted as follows:
11	272		Joint negotiations by dental providers with dental insurers.
12	273		1. As authorized under this section, a dental provider and a dental insurer may enter into
13		-	voluntary non - fee - related joint negotiations. Before commencing voluntary joint negotiations, a
14		-	joint negotiation representative shall notify the attorney general of its intent to engage in
15		-	voluntary joint negotiations. The notice must be in writing and include:
	274	+	voluntary non-fee-related joint negotiations. Before commencing voluntary joint
	275	+	negotiations, a joint negotiation representative shall notify the attorney general of its
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	309	+	intent to engage in voluntary joint negotiations. The notice must be in writing and
	310	+	include:
16	311		a. The matters, including terms and conditions, to be negotiated;
17	312		b. The identity and location of all dental providers participating in the voluntary joint
18	313		negotiations;
19		-	c.The identity, location, and market share of the dental insurer the dental providers seek to
20		-	engage in voluntary joint negotiations;
21		-	d.A statement explaining the circumstances create the need for voluntary joint negotiations
22		-	and the benefits anticipated from the voluntary joint negotiations; and
23		-	e.The joint negotiation representative's procedures to ensure compliance with this section.
24		-	2.At the time of the filing with the attorney general, the joint negotiation representative shall
25		-	provide a copy to the dental insurer of its notice and any other materials submitted to the
26		-	attorney general. The dental insurer may provide additional information to the attorney general
27		-	regarding matters described in this section.
28		-	3.The attorney general shall review the notice to determine whether the proposed voluntary joint
29		-	negotiations comply with law and public policy, and shall, within ninety days, unless a thirty
30		-	day extension is approved by the parties, notify the joint negotiation representative and the
31		-	dental insurer whether voluntary joint negotiations are authorized under this section. The
32		-	attorney general, in determining whether voluntary joint negotiations are authorized, shall
33		-	consider the following factors:
	314	+	c. The identity, location, and market share of the dental insurer the dental providers
	315	+	seek to engage in voluntary joint negotiations;
	316	+	d. A statement explaining the circumstances create the need for voluntary joint
	317	+	negotiations and the benefits anticipated from the voluntary joint negotiations;
	318	+	and
	319	+	e. The joint negotiation representative's procedures to ensure compliance with this
	320	+	section.
	321	+	2. At the time of the filing with the attorney general, the joint negotiation representative
	322	+	shall provide a copy to the dental insurer of its notice and any other materials
	323	+	submitted to the attorney general. The dental insurer may provide additional
	324	+	information to the attorney general regarding matters described in this section.
	325	+	3. The attorney general shall review the notice to determine whether the proposed
	326	+	voluntary joint negotiations comply with law and public policy, and shall, within ninety
	327	+	days, unless a thirty day extension is approved by the parties, notify the joint
	328	+	negotiation representative and the dental insurer whether voluntary joint negotiations
	329	+	are authorized under this section. The attorney general, in determining whether
	330	+	voluntary joint negotiations are authorized, shall consider the following factors:
34	331		a. The stated necessity and anticipated benefits of voluntary joint negotiations;
35	332		b. The market and bargaining power of the parties;
36		-	c.A party's ability to control or steer consumers, dictate terms of contracts, impose final or
37		-	nonnegotiable terms, or dictate or limit products or services available or offered to
38		-	consumers;
39		-	d.The contract terms to be negotiated, and the contract terms' potential effect on the ability
40		-	to provide quality care or medically appropriate care without delay and difficulty; S. B. NO. 2375 - PAGE 2
	333	+	c. A party's ability to control or steer consumers, dictate terms of contracts, impose
	334	+	final or non-negotiable terms, or dictate or limit products or services available or
	335	+	offered to consumers;
	336	+	d. The contract terms to be negotiated, and the contract terms' potential effect on
	337	+	the ability to provide quality care or medically appropriate care without delay and
	338	+	difficulty;
41	339		e. The risk of anticompetitive effects; and
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42	373		f. The potential effect on price, quality, choice, or access to products or services for
43	374		consumers or others.
44		-	4.The attorney general may request additional information from the parties at any point during
45		-	the process or during the parties' negotiations.
46		-	5.Upon a determination by the attorney general that voluntary joint negotiation is authorized
47		-	under this section, and after a duly authorized officer of the dental insurer and all dental
48		-	providers seeking voluntary joint negotiations have granted written consent, two or more
49		-	dental providers practicing in the service area of the dental insurer may jointly engage in
50		-	voluntary negotiations with the dental insurer regarding the following non - fee - related matters:
	375	+	4. The attorney general may request additional information from the parties at any point
	376	+	during the process or during the parties' negotiations.
	377	+	5. Upon a determination by the attorney general that voluntary joint negotiation is
	378	+	authorized under this section, and after a duly authorized officer of the dental insurer
	379	+	and all dental providers seeking voluntary joint negotiations have granted written
	380	+	consent, two or more dental providers practicing in the service area of the dental
	381	+	insurer may jointly engage in voluntary negotiations with the dental insurer regarding
	382	+	the following non-fee-related matters:
51	383		a. Definition of medical necessity and other conditions of coverage.
52	384		b. Utilization management criteria and procedures.
53	385		c. Clinical practice guidelines.
54	386		d. Preventative care and other medical management policies.
55	387		e. Patient referral standards and procedures.
56	388		f. Drug formularies and standards for prescribing off-formulary drugs.
57	389		g. Quality assurance programs.
58	390		h. Liability terms for a dental provider and dental insurer.
59	391		i. Administrative procedures.
60		-	j.Credentialing standards and procedures for selection, retention, and termination of
61		-	participating dentists.
62		-	k.Mechanisms for resolving disputes between the dental insurer and dental providers.
63		-	l.Inclusion or alteration of a contractual term or condition, unless the inclusion or alteration
64		-	is otherwise required by federal or state law.
65		-	6.As used in this section, "fee - related matters" includes the amount of payment, the amount of
66		-	discount, procedure codes or descriptions of services covered by payment, appropriate
67		-	grouping of procedure codes, and any other matter directly relating to the amount of
68		-	reimbursements paid to or revenue received by dental providers.
	392	+	j. Credentialing standards and procedures for selection, retention, and termination
	393	+	of participating dentists.
	394	+	k. Mechanisms for resolving disputes between the dental insurer and dental
	395	+	providers.
	396	+	l. Inclusion or alteration of a contractual term or condition, unless the inclusion or
	397	+	alteration is otherwise required by federal or state law.
	398	+	6. As used in this section, "fee-related matters" includes the amount of payment, the
	399	+	amount of discount, procedure codes or descriptions of services covered by payment,
	400	+	appropriate grouping of procedure codes, and any other matter directly relating to the
	401	+	amount of reimbursements paid to or revenue received by dental providers.
69	402		7. a. Upon a determination by the attorney general that voluntary joint negotiations are
70		-	authorized under this section, dental providers may communicate with each other and a
71		-	joint negotiation representative authorized to negotiate on behalf of the dental providers
72		-	with the dental insurer concerning any contractual term or condition to be negotiated,
73		-	subject to any limitations imposed by the attorney general. As used in this section, a "joint
74		-	negotiation representative" means a representative selected by two or more independent
75		-	dental providers to engage in voluntary joint negotiations with a dental insurer on behalf
76		-	of the dental providers.
77		-	b.The dental providers may agree to be bound by the terms and conditions negotiated by
78		-	the joint negotiation representative.
79		-	8.A person may not act as a joint negotiation representative without express permission from the
80		-	office of the attorney general. S. B. NO. 2375 - PAGE 3
81		-	9.a.Upon the joint negotiation representative and dental insurer determining a voluntary
82		-	agreement has been reached on contractual terms or conditions that are the subject
83		-	matter of the negotiations, the joint negotiation representative shall submit to the attorney
84		-	general, for its determination, a copy of the proposed contract or agreed upon terms
85		-	between the dental providers and the dental insurer. At the time of the submission to the
86		-	attorney general, the joint negotiation representative shall provide a copy of the proposed
87		-	materials submitted to the attorney general to the dental insurer, which may provide
88		-	additional information to the attorney general regarding the matters in this section.
89		-	b.Within ninety days of receipt of the proposed contract or agreed upon terms, the attorney
90		-	general shall review the proposed contract or agreed upon terms and provide a
91		-	determination.
92		-	c.The attorney general may consider the following factors in reviewing a proposed contract
93		-	or term, a negotiated contract or term, and the plan of action for implementing a
94		-	negotiated contract or term under this section:
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	437	+	and a joint negotiation representative authorized to negotiate on behalf of the
	438	+	dental providers with the dental insurer concerning any contractual term or
	439	+	condition to be negotiated, subject to any limitations imposed by the attorney
	440	+	general. As used in this section, a "joint negotiation representative" means a
	441	+	representative selected by two or more independent dental providers to engage
	442	+	in voluntary joint negotiations with a dental insurer on behalf of the dental
	443	+	providers.
	444	+	b. The dental providers may agree to be bound by the terms and conditions
	445	+	negotiated by the joint negotiation representative.
	446	+	8. A person may not act as a joint negotiation representative without express permission
	447	+	from the office of the attorney general.
	448	+	9. a. Upon the joint negotiation representative and dental insurer determining a
	449	+	voluntary agreement has been reached on contractual terms or conditions that
	450	+	are the subject matter of the negotiations, the joint negotiation representative
	451	+	shall submit to the attorney general, for its determination, a copy of the proposed
	452	+	contract or agreed upon terms between the dental providers and the dental
	453	+	insurer. At the time of the submission to the attorney general, the joint negotiation
	454	+	representative shall provide a copy of the proposed materials submitted to the
	455	+	attorney general to the dental insurer, which may provide additional information to
	456	+	the attorney general regarding the matters in this section.
	457	+	b. Within ninety days of receipt of the proposed contract or agreed upon terms, the
	458	+	attorney general shall review the proposed contract or agreed upon terms and
	459	+	provide a determination.
	460	+	c. The attorney general may consider the following factors in reviewing a proposed
	461	+	contract or term, a negotiated contract or term, and the plan of action for
	462	+	implementing a negotiated contract or term under this section:
95	463		(1) Fairness of the contract and whether the contract terms are consistent with
96	464		applicable laws and regulations;
97	465		(2) Details provided about the negotiation process;
98	466		(3) The market and bargaining power of the parties;
99	467		(4) The contract terms and the benefits achieved by the parties;
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100	501		(5) Potential benefit to consumers and other purchasers of dental insurance;
101		-	(6)Risk of harm to consumers and others, including the likelihood of increase in prices
102		-	or reduction in quality, choice, or access to dental care or dental insurance;
103		-	(7)Risk of anticompetitive effects and potential effects on third parties, including
104		-	creation of barriers to entry for new market participants, unfair competition, or
105		-	exclusionary effects; and
	502	+	(6) Risk of harm to consumers and others, including the likelihood of increase in
	503	+	prices or reduction in quality, choice, or access to dental care or dental
	504	+	insurance;
	505	+	(7) Risk of anticompetitive effects and potential effects on third parties,
	506	+	including creation of barriers to entry for new market participants, unfair
	507	+	competition, or exclusionary effects; and
106	508		(8) Promotion of increased infrastructure and innovation in a market.
107	509		d. Upon request from the attorney general, the joint negotiation representative, a
108		-	participating dental provider, and the dental insurer shall provide additional ~~information to~~
109		-	inform the attorney general's determination under this section.
	510	+	participating dental provider, and the dental insurer shall provide additional
	511	+	information to inform the attorney general's determination under this section.
110	512		10. The attorney general may adopt rules and procedures as necessary to carry out the
111	513		responsibilities of this section.
112		-	11.This section does not apply to dental benefit plans providing covered services ~~exclusively or~~
113		-	primarily to individuals who are eligible for medical assistance.
	514	+	11. This section does not apply to dental benefit plans providing covered services
	515	+	exclusively or primarily to individuals who are eligible for medical assistance.
114	516		12. This section may not be construed to:
115	517		a. Permit a coordinated cessation, reduction, or limitation of dental services.
116		-	b.Affect government approval of, or otherwise restrict activity by, dental providers which is
117		-	not prohibited under federal antitrust law or require approval or contract terms to the
118		-	extent the terms are exempt from state regulation under federal law. S. B. NO. 2375 - PAGE 4
119		-	____________________________ ____________________________
120		-	President of the Senate Speaker of the House
121		-	____________________________ ____________________________
122		-	Secretary of the Senate Chief Clerk of the House
123		-	This certifies that the within bill originated in the Senate of the Sixty-ninth Legislative Assembly of North
124		-	Dakota and is known on the records of that body as Senate Bill No. 2375.
125		-	Senate Vote:Yeas 44 Nays 2 Absent 1
126		-	House Vote: Yeas 78 Nays 14 Absent 2
127		-	____________________________
128		-	Secretary of the Senate
129		-	Received by the Governor at ________M. on _____________________________________, 2025.
130		-	Approved at ________M. on __________________________________________________, 2025.
131		-	____________________________
132		-	Governor
133		-	Filed in this office this ___________day of _______________________________________, 2025,
134		-	at ________ o’clock ________M.
135		-	____________________________
136		-	Secretary of State
	518	+	b. Affect government approval of, or otherwise restrict activity by, dental providers
	519	+	which is not prohibited under federal antitrust law or require approval or contract
	520	+	terms to the extent the terms are exempt from state regulation under federal law.
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