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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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Voting opens for North Dakota ‘I Voted’ sticker contest

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Voting opens for North Dakota ‘I Voted’ sticker contest


North Dakotans can help choose the state’s next “I Voted” sticker from a group of five finalists. The public can vote for their favorite at sos.nd.gov/stickervote through Jan. 23. From kindergarteners to grandparents, 478 entries from 72 communities were submitted, the Secretary of State’s Office said. The finalists feature a bald eagle, a prairie dog, […]



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How two property tax credits could reduce — or eliminate — 2026 tax bills

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How two property tax credits could reduce — or eliminate — 2026 tax bills


DICKINSON — Property tax bills are arriving, and as inflation, taxes and property values continue to rise, many North Dakota homeowners are feeling the strain of higher household expenses.

Two state programs — the primary residence credit and the homestead property tax credit — aim to ease that burden by reducing, and in some cases eliminating, property taxes for eligible homeowners.

The primary residence credit provides a flat credit of up to $1,600 for qualifying homeowners, regardless of age or income. The homestead credit, meanwhile, reduces the taxable value of a home for seniors and individuals with disabilities, significantly lowering or eliminating their tax bill.

Eligible households may apply for both credits, further reducing the amount owed.

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Primary residence credit: Who qualifies and how much is available

The primary residence credit was originally capped at $500 in 2023. In 2025, lawmakers increased the credit to $1,600 after Gov. Kelly Armstrong signed House Bill 1176 into law on May 3, 2025.

To qualify, a homeowner must own and occupy a home in North Dakota as their primary residence. Eligible properties include houses,

mobile homes

, townhomes, duplexes and condominiums. Homes held in trust also qualify. There are no age or income limits, and only one credit is allowed per household.

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The credit may be applied up to the amount of property tax owed.

“We’re asking the public to take just a few minutes — please come to us, tell us who you are,” State Tax Commissioner Brian Kroshus said during a press briefing at the Capitol on Dec. 19. “That is the difference between applying the credit across the board and diluting it for everyone or having a larger credit amount of $1,600.”

Armstrong also highlighted the impact of the expanded credit in an

opinion column

.

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“Since we more than tripled the credit to $1,600, the number of households paying no property taxes in 2025 has increased to 50,000,” he wrote.

Homestead property tax credit: Using health expenses to qualify

Unlike the primary residence credit, the homestead credit reduces the taxable value of a qualifying home.

To be eligible, applicants must be 65 or older or have a permanent or total disability, own and occupy the home as their primary residence, and have a household income of $70,000 or less. There is no age requirement for individuals with disabilities. Only one spouse may apply if a married couple lives together.

Households earning $40,000 or less may qualify for a 100% reduction in taxable value, up to $9,000. Those earning between $40,001 and $70,000 may qualify for a 50% reduction, up to $4,500.

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Out-of-pocket medical expenses can be deducted when calculating household income. Eligible expenses include unreimbursed medical costs paid during the prior year for the homeowner, spouse or dependents. Subtracting those expenses may move applicants into a lower income tier or help them qualify.

Stark County Auditor and Treasurer

Karen Richard

said the credit has eliminated tax bills for many approved applicants.

“Out of the 725 approved homestead credit applications, there were 355 applicants who had a zero-dollar tax bill just from receiving the homestead credit,” Richard said.

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She added that participation remains low.

“There are most likely many more seniors who qualify but do not realize the homestead credit exists,” Richard said. “Any way possible to get the word out could really help individuals living on fixed incomes.”

Applying for both credits

Some households qualify for both programs. The homestead credit is applied first, followed by the primary residence credit.

“By applying for and receiving both credits, an additional 149 applicants received a zero-dollar tax bill,” Richard said. “Out of 725 approved homestead applicants, 504 owed nothing for 2025 property taxes.”

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It’s also important to note that either credit applies to special assessments, which may still result in a balance owed.

Applications for both credits must be submitted to a local assessor or county director of tax equalization between Jan. 1 and April 1 of the year the credit is requested. For 2026 taxes, the deadline is April 1, 2026.

Sarah Ruffin, who processes homestead and veterans credit applications for Stark County, encouraged seniors to seek assistance if needed.

“If you are over 65, own your home and earn under $70,000 per year, come talk to me about the homestead credit,” Ruffin said.

Homestead credit applications are available at

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tax.nd.gov/homestead

.Primary residence credit applications must be completed online at

tax.nd.gov/prc

.

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“The pen is mightier than the sword.”
As a professional writer with more than 10 years of experience, Kelly lives by these words. With a bachelor’s degree in communication, majoring in broadcasting and journalism, and a fiery passion for writing that began in childhood, she uses the power of words to make an impact in the community — informing, educating, and entertaining a wide range of audiences.
As a journalist, what Kelly loves most about her job is the ability to bring unique stories to the public and give people a voice that can be heard around the world. Whether through print or digital platforms, her goal is to share stories people enjoy reading while spreading valuable information that supports the welfare of southwest North Dakota and its people.





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North Dakota U.S Rep. Julie Fedorchak announces reelection campaign

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North Dakota U.S Rep. Julie Fedorchak announces reelection campaign


North Dakota U.S. Rep. Julie Fedorchak, R-N.D., announced her reelection campaign Monday in a video posted to social media. In the video, Fedorchak is described as someone who supports the “America first” agenda and will keep North Dakota as her “top priority.” “As a fourth-generation North Dakotan, I want the very best state and nation […]



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