North Dakota
Advocates push for infertility benefit coverage in North Dakota
BISMARCK — The issue of infertility is essentially missed as a result of it’s a kind of topics folks don’t need to discuss.
However research estimate that certainly one of each eight {couples} is unable to conceive a baby — a ratio that equates to about 20,000 North Dakota residents.
“It’s lots of people,” stated Tara Brandner, a nurse practitioner in Ashley. “They’re invisible,” stored within the shadows by the stigma connected to infertility.
The price of medical infertility remedies is excessive, averaging round $10,000 for a lot of {couples}, but will not be lined by most well being insurers, Brandner stated.
Twice the North Dakota Legislature has been requested to require infertility protection, and twice the proposals have been rejected, final yr failing 31 to 63 within the North Dakota Home of Representatives.
“We greater than doubled our help from the primary yr to the second yr,” Brander stated Monday, June 20. “I really feel extra constructive yearly we transfer ahead.”
So, she is again with a
proposed invoice
launched through the legislative interim and as soon as once more hopes to discover a bipartisan slate of sponsors.
The interim draft invoice will get its first take a look at Tuesday when it is going to be thought-about by the interim
Worker Advantages Applications Committee.
The invoice seeks to extend infertility therapy protection for public staff within the North Dakota Public Worker Retirement System from $20,000 to $50,000. If that succeeds, Brandner hopes after two years the profit can be required for personal insurance coverage.
Though the price of infertility remedies is often $10,00 to $20,000, many pay extra, and in uncommon circumstances the prices can exceed $200,000, Brandner stated, making the remedies unaffordable to many.
Opposition stems from considerations that an infertility therapy profit would drive up insurance coverage prices. A latest examine cited by Brander, nonetheless, discovered 91% of employers providing infertility therapy protection haven’t skilled will increase of their medical prices.
Thus far, 20 states require insurance coverage protection for infertility remedies, and one other 4 are contemplating the requirement,
based on Resolve
, the nationwide infertility affiliation. Minnesota and South Dakota don’t require protection, however Montana does.
Blue Cross Blue Protect of North Dakota, the state’s largest personal well being insurer, encourages staff to advocate that their employers increase protection to incorporate in vitro fertilization remedies.
“We share within the perception that change must happen to deal with the unbelievable prices of infertility therapy,” Andrea Dineen, a spokeswoman for Blue Cross Blue Protect, stated in a press release.
As an alternative of mandating infertility protection by regulation, a greater strategy can be “working extra broadly to higher handle the prices of those providers and coverings themselves. Mandates drive up the general price of well being care,” she stated.
“Legislatively selecting and selecting which medical providers will obtain mandated protection is a slippery slope that prioritizes one individual’s situation over one other’s, reminiscent of insulin, most cancers therapy, and so forth.,” Dineen added.
The Facilities for Medicare and Medicaid lately gave discover that states will likely be held financially liable for any advantages past the important well being advantages, “which implies the state of North Dakota will probably be liable for the price of this proposed mandate,” Dineen stated.
Sanford Well being Plan is “constantly evaluating its protection choices to make sure it’s assembly members’ healthcare wants whereas holding premiums inexpensive,” spokesman Nathan Aamodt stated in a press release. “This contains trying into choices to higher handle premium prices for all plan members and evaluating the monetary affect to these members present process fertility remedies.”
Brandner’s work as a nurse practitioner uncovered her to the anguish of fogeys who’re unable to conceive and moved her to type a nonprofit group, Eternal Hope, in 2019.
The charity’s fundraising has supplied grants of $2,000 to $5,000 which have helped allow the births of 5 infants, with one other 4 on the way in which, she stated.
Research have proven infertility advantages can assist scale back a number of births as a result of {couples} have monetary help and are much less probably to decide on choices that can lead to a number of births, she stated. In flip, that helps scale back neonatal intensive care prices, that are extra probably in a number of births.
Brandner believes help for infertility insurance coverage advantages is rising in North Dakota. She hopes extra {couples} will come ahead to inform their tales.
North Dakota
European potato company plans first U.S. production plant in North Dakota
Agristo, a leading European producer of frozen potato products, is making big moves in North America. The company, founded in 1986, has chosen Grand Forks, North Dakota, as the site for its first U.S. production facility.
Agristo has been testing potato farming across the U.S. for years and found North Dakota to be the perfect fit. The state offers high-quality potato crops and a strong agricultural community.
In a statement, Agristo said it believes those factors make it an ideal location for producing the company’s high-quality frozen potato products, including fries, hash browns, and more.
“Seeing strong potential in both potato supply and market growth in North America, Agristo is now ready to invest in its first production facility in the United States, focusing on high-quality products, innovation, and state-of-the-art technology.”
Agristo plans to invest up to $450 million to build a cutting-edge facility in Grand Forks. This project will create 300 to 350 direct jobs, giving a boost to the local economy.
Agristo is working closely with North Dakota officials to finalize the details of the project.
Negotiations for the plant are expected to wrap up by mid-2025.
For more information about Agristo and its products, visit www.agristo.com.
Agristo’s headquarters are located in Belgium.
North Dakota
Audit of North Dakota state auditor finds no issues; review could cost up to $285K • North Dakota Monitor
A long-anticipated performance audit of the North Dakota State Auditor’s Office found no significant issues, consultants told a panel of lawmakers Thursday afternoon.
“Based on the work that we performed, there weren’t any red flags,” Chris Ricchiuto, representing consulting firm Forvis Mazars, said.
The review was commissioned by the 2023 Legislature following complaints from local governments about the cost of the agency’s services.
The firm found that the State Auditor’s Office is following industry standards and laws, and is completing audits in a reasonable amount of time, said Charles Johnson, a director with the firm’s risk advisory services.
“The answer about the audit up front is that we identified four areas where things are working exactly as you expect the state auditor to do,” Johnson told the committee.
The report also found that the agency has implemented some policies to address concerns raised during the 2023 session.
For example, the Auditor’s Office now provides cost estimates to clients before they hire the office for services, Johnson said. The proposals include not-to-exceed clauses, so clients have to agree to any proposed changes.
The State Auditor’s Office also now includes more details on its invoices, so clients have more comprehensive information about what they’re being charged for.
The audit originally was intended to focus on fiscal years 2020 through 2023. However, the firm extended the scope of its analysis to reflect policy changes that the Auditor’s Office implemented after the 2023 fiscal year ended.
State Auditor Josh Gallion told lawmakers the period the audit covers was an unusual time for his agency. The coronavirus pandemic made timely work more difficult for his staff. Moreover, because of the influx of pandemic-related assistance to local governments from the federal government, the State Auditor’s Office’s workload increased significantly.
Gallion said that, other than confirming that the changes the agency has made were worthwhile, he didn’t glean anything significant from the audit.
“The changes had already been implemented,” he said.
Gallion has previously called the audit redundant and unnecessary. When asked Thursday if he thought the audit was a worthwhile use of taxpayer money, Gallion said, “Every audit has value, at the end of the day.”
The report has not been finalized, though the Legislative Audit and Fiscal Review Committee voted to accept it.
Audit of state auditor delayed; Gallion calls it ‘redundant, unnecessary’
“There was no shenanigans, there were no red flags,” Sen. Jerry Klein, R-Fessenden, said at the close of the hearing.
Forvis representatives told lawmakers they plan to finish the report sometime this month.
The contract for the audit is for $285,000.
Johnson said as far as he is aware Forvis has sent bills for a little over $150,000 so far. That doesn’t include the last two months of the company’s work, he said.
The consulting firm sent out surveys to local governments that use the agency’s services.
The top five suggestions for improvements were:
- Communication with clients
- Timeliness
- Helping clients complete forms
- Asking for same information more than once
- Providing more detailed invoices
The top five things respondents thought the agency does well were:
- Understanding of the audit process
- Professionalism
- Willingness to improve
- Attention to detail
- Helpfulness
Johnson said that some of the survey findings should be taken with a “grain of salt.”
“In our work as auditors, we don’t always make people happy doing what we’re supposed to do,” he said.
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North Dakota
'False promise' or lifesaver? Insulin spending cap returns to North Dakota Legislature
BISMARCK — A bill introduced in the North Dakota House of Representatives could cap out-of-pocket insulin costs for some North Dakotans at $25 per month.
The bill also includes a monthly cap for insulin-related medical supplies of $25.
With insulin costing North Dakota residents billions of dollars each year,
House Bill 1114
would provide relief for people on fully insured plans provided by individual, small and large group employers. People on self-funded plans would not be affected.
“I call insulin liquid gold,” Nina Kritzberger, a 16-year-old Type 1 diabetic from Hillsboro, told lawmakers. “My future depends on this bill.”
HB 1114 builds on
legislation
proposed during the 2023 session that similarly sought to establish spending caps on insulin products.
Before any health insurance mandate is enacted,
state law
requires the proposed changes first be tested on state employee health plans.
As such, the legislation was altered to order the state Public Employees Retirement System, or PERS, to introduce an updated bill based on the implementation of a $25 monthly cap on a smaller scale.
The updated bill — House Bill 1114 — would bring the cap out of PERS oversight and into the North Dakota Insurance Department, which regulates the fully insured market but not the self-insured market.
Employers that provide self-insured health programs use profits to cover claims and fees, acting as their own insurers.
Fully insured plans refer to employers that pay a third-party insurance carrier a fixed premium to cover claims and fees.
“It (the mandate) doesn’t impact the entire insurance market within North Dakota,” PERS Executive Director Rebecca Fricke testified during a Government and Veterans Affairs Committee meeting on Thursday, Jan. 9.
Blue Cross Blue Shield Vice President Megan Hruby told the committee that two-thirds of the provider’s members would not be eligible for the monthly cap, calling the bill a “false promise.”
“We do not make health insurance more affordable by passing coverage mandates, as insurance companies don’t pay for mandates. Policy holders pay for mandates in the form of increased premiums,” Hruby said.
She touted the insurance provider having already placed similar caps on insulin products and said companies should be making those decisions, not the state government.
Sanford Health and the Greater North Dakota Chamber also had representatives testify against the bill.
Advocates for the spending cap said higher premiums are worth lowering the cost of insulin drugs and supplies.
“One of the first things that people ask me about is, ‘Why should I pay for your insulin?’ And my response is, ‘Why should I have to pay for your premiums?’” Danelle Johnson, of Horace, said in her testimony.
If adopted and as written, the spending caps brought by
House Bill 1114
would apply to the North Dakota commercial insurance market and cost the state around $834,000 over the 2025-27 biennium.
According to the 2024 North Dakota diabetes report,
medical fees associated with the condition cost North Dakotans over $306 billion in 2022.
The state has more than 57,200 adults diagnosed with diabetes, and a staggering 38% have prediabetes — a condition where blood sugar levels are high but not high enough to cause Type 2 diabetes.
Nearly half of those people are adults 65 years old or older.
North Dakotan tribal members were also found to be twice as likely to have diabetes compared to their white counterparts.
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