North Dakota
North Dakota Gov. Kelly Armstrong signs bill to put checks on AI health care decisions
BISMARCK — A new North Dakota law is expected to put checks on the influence that artificial intelligence and algorithms have on health care decisions, resulting in fewer delays in treatment and medication for patients.
On Wednesday, April 23, Gov. Kelly Armstrong signed
Senate Bill 2280, which aims to reform the “prior authorization” process for patients needing imaging services, medications and surgeries.
Prior authorization is the approval from a patient’s health insurance provider that may be required for a service, treatment or prescription to be covered by their plan, if it’s not an emergency. Prior authorization does not guarantee payment, but makes it more likely their health plan will cover the cost.
The new North Dakota law puts deadlines on insurance plans for those prior authorization decisions and requires any denials to be made by a licensed physician, not by AI or insurance companies.
The bill passed unanimously in the House and nearly so in the Senate, and with Armstrong’s signature, takes effect Jan. 1, 2026.
Sen. Scott Meyer, R-Grand Forks, the bill’s lead sponsor, said it passed due to proponents and opponents sitting down and working it out.
“Just because it was a vote that led to almost unanimous support, it was still a lot of work to get to that point,” Meyer told The Forum.
Dr. Stefanie Gefroh, president of Essentia Health’s West Market, said North Dakota is one of only a few states without statewide oversight of prior authorization.
“It’s kind of an open book with no guard rails, essentially, around what is an acceptable time frame for a patient to receive clearance to get services,” Gefroh said.
She said some physicians are having to spend up to 14 hours a week trying to justify a medical decision made for a patient.
Meyer said American Medical Association data shows among all of the prior authorization requests in Medicare Advantage plans that were denied and appealed in 2022, more than 83% were overturned.
The result was delays in care, treatment and medications for those patients.
Gefroh said most delays involve higher cost items: MRIs, surgeries, and chemotherapy and immunologic agents.
The law calls for insurance companies to make timely decisions; within seven days for non-urgent requests and 72 hours for urgent ones.
Requests for services that go unmet or unanswered are considered “authorized.”
“That’s why the default to ‘yes’ really is quite extraordinary, because the beautiful part of it is we’re not holding up patient care,” she said.
In addition, any denials for services must be made by licensed physicians experienced in the relevant condition, not by AI or insurance analysts.
Gefroh said insurance companies that don’t adhere to the guidelines will likely have to adjust their internal processes.
“I don’t think they want to be approving by default,” she said.
There was pushback against the bill from representatives of multiple insurance companies, who said it would increase costs.
In the end, the bill prevailed due to support from the North Dakota Hospital Association, and a coalition led by Essentia of 20 health care and patient advocacy organizations representing physicians, pharmacists, hospitals, physical therapists, and advocates for seniors, children, and cancer patients.
“It’s doing the right thing and putting the patients at the center and anytime we can put the highlight on that, I’m pleased,” Gefroh said.
JAMESTOWN, N.D. — The No. 2 seed Thompson Tommies survived an upset scare by defeating the No. 7 seed Rugby Panthers 39-36 on Thursday, March 5, in the quarterfinals of the North Dakota Division A girls basketball state tournament at the Jamestown Civic Center.
With 16 seconds left in the game and down 39-36, Panthers coach Jen Brossart drew up one final play in an attempt to send the game to overtime. Strong defense from the Tommies formed a cluster of players at the top of the arc, and as time expired, Panthers guard Avery Santjer put up a falling-away 3-point attempt that came up short, giving the quarterfinal victory to Thompson.
Addison Sage had 15 points to lead Thompson with Kya Hurst chipping in 11. Santjer led Rugby with 13.
Burchill’s double-double leads Valley City to win
Valley City junior forward Katie Burchill scored a 23-point double-double with 18 rebounds to lead the Hi-Liners to a 64-44 quarterfinal victory over Devils Lake on Thursday.
Valley City outscored Devils Lake 21-6 in the third quarter to take a commanding lead.
Presley Brown and Tylie Brodina each scored 12 for the Firebirds.
Burchill and sophomore forward Skye Nelson also recorded nine of Valley City’s 12 blocks.
John M. Steiner / The Jamestown Sun
South Prairie-Max runs past Watford City
South Prairie-Max scored a 50-point victory over Watford City, winning 75-25 on Thursday in the quarterfinals behind 19 points from Skotti Beck.
Mya Gunville added 12 points and Brianna Rose 11 for South Prairie-Max.
Lohgan Hanna led Watford City with nine points.
Trenbeath, Kindred squeak by Hazen
Liza Trenbeath’s 27 points paced No. 4 seed Kindred to a 56-54 win over No. 5 Hazen in Thursday’s quarterfinals.
Siera Nipstad chipped in 19 points and six rebounds as the Vikings (20-5) advanced to Friday’s state semifinals against top-seeded South Prairie-Max (24-1). Tipoff is set for 8:15 p.m. at the Jamestown Civic Center.
Kindred shot 22 of 51 (43.1%) from the field to Hazen’s 19 of 41 (46.3%)
Our newsroom occasionally reports stories under a byline of “staff.” Often, the “staff” byline is used when rewriting basic news briefs that originate from official sources, such as a city press release about a road closure, and which require little or no reporting. At times, this byline is used when a news story includes numerous authors or when the story is formed by aggregating previously reported news from various sources. If outside sources are used, it is noted within the story.
Greg Power, fisheries division chief with the North Dakota Game and Fish Department, shares information about the new 2026-2028 Fishing Guide and a few new regulations starting April 1, 2026.
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SIOUX FALLS — Ali Stephens had 17 points and 13 rebounds and 8th-seeded Omaha defeated 9th-seeded North Dakota 49-39 in the first round of the Summit League women’s tournament.
The Fighting Hawks had a tough time putting the ball in the hoop all night long, scoring just three points in the first quarter and having only marginally better luck from there.
UND (7-24) shot just 23.5 percent from the floor (12-for-51) and made 1-of-20 shots from outside the arc. Walker Demers and Mackenzie Hughes had 10 points each to lead the Hawks, with Demers adding eight rebounds.
Matt Zimmer/Sioux Falls Live
Regan Juenemann had 10 points and five rebounds for the Mavericks while Avril Smith had seven points and 16 rebounds and Sarai Estupinan eight points, five assists and three rebounds. Omaha (6-26) shot the ball slightly better than the Hawks, going 16-of-53 from the field (30 percent) and 8-of-23 (35 percent) on 3-pointers.
With the win, the Mavs earn a date with top-seed North Dakota State on Thursday at 2:30 p.m.
The Bison won both regular season matchups by more than 50 points.
Matt Zimmer/Sioux Falls Live
Oral Roberts 84, Kansas City 62 — Don’t look now but the team that started the conference season 0-10 and at one point lost 15 of 16 games might be the hottest in the Summit League.
Oral Roberts picked up their fourth straight victory on Wednesday night in the conference tournament opener, routing Kansas City at the Premier Center in the 8/9 “play-in” game.
Ty Harper had 22 points to lead the Golden Eagles (10-22), who took a 44-21 lead by halftime and never looked back. ORU shot 50 percent from the floor and made 13-of-27 3-pointers while the Kangaroos shot just 34 percent and made 6-of-24 from deep. Martins Kilups had 17 points for the Eagles and Connor Dow added 14.
Jayson Petty had 14 points to lead the Kagaroos, who finish the season 4-27. It was their final game under coach Marvin Menzies, whom the school announced earlier this season would not return next year.
With the win ORU advances to face top-seed North Dakota State on Thursday at 6 p.m.
The Golden Eagles lost to NDSU 86-58 in Tulsa on Jan. 24 but they took the Bison to overtime in Fargo on Jan. 3 in a 79-77 loss.
Matt Zimmer is a Sioux Falls native and longtime sports writer. He graduated from Washington High School where he played football, legion baseball and developed his lifelong love of the Minnesota Twins and Vikings. After graduating from St. Cloud State University, he returned to Sioux Falls, and began a long career in amateur baseball and sports reporting. Email Matt at mzimmer@siouxfallslive.com.
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