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North Dakota Gov. Kelly Armstrong signs bill to put checks on AI health care decisions

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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.

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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.

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“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.

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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.

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“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.





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Donald Snyder Sr.

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Donald Snyder Sr.


Donald R. Snyder Sr. 82 of Grand Forks, North Dakota died Tuesday, December 9, 2026, at Villa St. Vincent in Crookston, Minnesota. 

Don was born on June 3, 1943, the son of Harrison and Gladys (Whittier) Snyder in Van Hook, North Dakota. He attended school in Van Hook and New Town, North Dakota. Don served in the United States Navy from 1960 – 1964 and was stationed in Hawaii during his time of service as a Military Police officer. He attended ND Police Academy and where he worked in Wattford City, ND and later was the Chief of Police in Parshall, ND. Don attended Minot State University and received a bachelor’s degree in psychology in 1972. 

Don was united in marriage to Greta Huseby on November 22, 1991, in Lake Tahoe, Neveda. He worked as a social worker in child welfare in North Dakota for thirty-five plus years in various roles in the state in Rugby, Minot and Bismarck as a Regional Supervisor to State Director in foster care. Don spent the many years taking care of family’s needs in North Dakota.

After retiring from Human Service in North Dakota, he worked for Multiband Inc. and Orangehook Inc. Don retired from OrangeHook Inc. as the Senior Vice President, responsible for HR Department.

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Don enjoyed fishing (deep sea, rivers and lakes), hunting, woodworking (cabinetry and interior), coaching Tee Ball and soccer, and volunteering for the local honor guards. He was proud of his service in the military and always showed his gratitude for fellow veterans.

Don’s faith and family were his priority. He read the Bible six times and shared his faith with his family and friends. Don and Greta were active members of University Lutheran Church.

Don is survived by his wife, Greta Snyder; three sons, Donald Richard Snyder Jr., Scott (Nancy) Snyder and Tracy (Staci) Snyder; grandchildren, Megan (Rory) Selk, Katelyn Snyder, Gavin Snyder, Whitney (Chris) Crofts, Kaylee (Jon) Gappmaier and Jordan (Jen) Snyder, thirteen great-grandchildren, Kinley, Iyla, Jude, Gabby, Rowan, Sophia, Hunter, Kimber, Isaiah, Benjamin, Porshea, Addie and Mollie;  numerous nieces and nephews.

Don was preceded in death by his parents, two daughters, Tunya and Mishell Snyder, granddaughter, Jessica Snyder and two infant sisters. 

Visitation will be held from 10:00 – 11:00 a.m. Wednesday, December 17, 2025, at Amundson Funeral Home. Memorial service will be held at 11:00 a.m. Wednesday, December 17, 2025, at Amundson Funeral Home.

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Wheeler-Thomas scores 21 as North Dakota State knocks off Cal State Bakersfield 80-69

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Wheeler-Thomas scores 21 as North Dakota State knocks off Cal State Bakersfield 80-69


BAKERSFIELD, Calif. (AP) — Damari Wheeler-Thomas’ 21 points helped North Dakota State defeat Cal State Bakersfield 80-69 on Thursday.

Wheeler-Thomas had three steals for the Bison (8-3). Markhi Strickland scored 15 points while shooting 6 of 11 from the field and 3 for 6 from the free-throw line and grabbed five rebounds. Andy Stefonowicz went 4 of 7 from the field (3 for 4 from 3-point range) to finish with 13 points.

Ron Jessamy led the way for the Roadrunners (4-7) with 18 points, six rebounds, two steals and four blocks. CJ Hardy added 13 points. Jaden Alexander also recorded eight points and two steals.

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The Associated Press created this story using technology provided by Data Skrive and data from Sportradar.



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Scientists discover ancient river-dwelling mosasaur in North Dakota

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Scientists discover ancient river-dwelling mosasaur in North Dakota


Some 66 million years ago, a city bus-sized terrifying predator prowled a prehistoric river in what is now North Dakota. 

This finding is based on the analysis of a single mosasaur tooth conducted by an international team of researchers from the United States, Sweden, and the Netherlands. 

The tooth came from a prognathodontine mosasaur — a reptile reaching up to 11 meters long. This makes it an apex predator on par with the largest killer whales.

It shows that massive mosasaurs successfully adapted to life in rivers right up until their extinction.

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The mosasaur tooth was found in 2022 in the Bismarck Area, North Dakota. Credit: Melanie During 

Isotope analysis

Dating from 98 to 66 million years ago, abundant mosasaur fossils have been uncovered in marine deposits across North America, Europe, and Africa.

However, these marine reptile fossils have been rarely found in North Dakota before. 

In this new study, the large mosasaur tooth was unearthed in a fluvial deposit (river sediment) in North Dakota. 

Its neighbors in the dirt were just as compelling: a tooth from a Tyrannosaurus rex and a crocodylian jawbone. Interestingly, all these fossilized remains came from a similar age, around 66 million years old. 

This unusual gathering — sea monster, land dinosaur, and river croc — raised an intriguing question: If the mosasaur was a sea creature, how did its remains end up in an inland river?

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The answer lay in the chemistry of the tooth enamel. Using advanced isotope analysis at the Vrije Universiteit in Amsterdam, the team compared the chemical composition of the mosasaur tooth with its neighbors.

The key was the ratio of oxygen isotopes. 

The mosasaur teeth contained a higher proportion of the lighter oxygen isotope than is typical for mosasaurs living in saltwater. This specific isotopic signature, along with the strontium isotope ratio, strongly suggests that the mosasaur lived in a freshwater habitat.

Analysis also revealed that the mosasaur did not dive as deep as many of its marine relatives and may have fed on unusual prey, such as drowned dinosaurs. 

The isotope signatures indicated that this mosasaur had inhabited this freshwater riverine environment. When we looked at two additional mosasaur teeth found nearby, slightly older sites in North Dakota, we saw similar freshwater signatures. These analyses show that mosasaurs lived in riverine environments in the final million years before going extinct,” explained Melanie During, the study author.

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Transformation of the Seaway

The adaptation occurred during the final million years of the Cretaceous period.

It is hypothesized that the mosasaurs were adapting to an enormous environmental shift in the Western Interior Seaway, the vast inland sea that once divided North America.

Increased freshwater influx gradually transformed the ancient sea from saltwater to brackish water, and finally to mostly freshwater, similar to the modern Gulf of Bothnia. 

The researchers hypothesize that this change led to the formation of a halocline: a structure where a lighter layer of freshwater rested atop heavier saltwater. The findings of the isotope analyses directly support this theory.

The analyzed mosasaur teeth belong to individuals who successfully adapted to the shifting environments. 

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This transition from marine to freshwater habitats (reverse adaptation) is considered less complex than the opposite shift and is not unique among large predators. 

Modern parallels include river dolphins, which evolved from marine ancestors but now thrive in freshwater, and the estuarine crocodile, which moves freely between freshwater rivers and the open sea for hunting.

Findings were published in the journal BMC Zoology on December 11.



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