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.
Miss America 2026 pageant coming to West Palm Beach, Florida
The Miss America pageant is coming to Palm Beach County for the next three years. Here’s what we can expect.
Kianna Healy of Hartford, South Dakota, was crowned Miss South Dakota 2026 at the competition on May 30.
Twenty-seven women competed for the title, which was a record number of candidates, according to a community announcement.
Healy, 23, graduated from O’Gorman High School and Pace University, where she majored in film and arts and entertainment management.
Healy won a $13,000 scholarship, a $1,000 preliminary talent award, a $500 preliminary fitness award and the $500 Callee Bauman Wachter top performing arts award.
Healy’s community service initiative is The Second Chance Project. For her talent, she performed “I’m a Star” by Scott Alan.
She is set to represent South Dakota at the Miss America Competition in September.
First runner-up was Amelie Wilcox of Rapid City, who earned a $5,000 scholarship. Wilcox also received the $5,000 South Dakota Strong award, the overall interview award ($1,000), a $1,000 community service award and the $500 Hunter Widvey Medical scholarship. She also took home the $1,000 Ray Peterson Rookie of the Year award for being the highest placing delegate competing at Miss South Dakota for the first time.
Second runner-up was Sydney Morgan of Hot Springs, who received a $4,000 scholarship and the $500 STEM scholarship. Third runner-up was Katie Milbrandt of Brookings, who earned a $3,000 scholarship and the $1,000 Quality of Life Award. Briley Steffensen of Hartford was fourth runner-up and won a preliminary fitness award, totaling $2,500 in awards and scholarships.
The top ten semi-finalists, each receiving a $750 scholarship, were Thea Tanton of Brookings, Lilly Mae Blume of Redfield, Javonte Madsen of Sioux Falls, Rylin Yerdon of Harrisburg and Natalie Biegler of Timber Lake. Tanton and Biegler tied for the preliminary talent award.
Additional awards included Laney Titze of Mitchell receiving $1,000 in the South Dakota Strong competition. Olivia Granaas, Jensine Matson and Taysan Rouselle each won $500 in the same category. Kyla Andvik of Fargo, North Dakota, earned the most talented non-semifinalist award ($250), while Jenisha Gurung received the highest score for non-finalist in interview ($250). The top fundraiser award ($500) went to Jayden Bender.
Miss Congeniality ($500) was awarded to Miss Northern State University Evelynn Carlson of Aberdeen. Each non-semi-finalist received a $300 scholarship, with total scholarships exceeding $60,000 for all participants.
This story was created by reporter Charles Rankin, crankin@salina.com, with the assistance of Artificial Intelligence (AI). Journalists were involved in every step of the information gathering, review, editing and publishing process. Learn more at cm.usatoday.com/ethical-conduct.
North Dakota
Armstrong applauds federal funding for upgrading coal infrastructure, including Antelope Valley Station
BISMARCK, N.D. – Gov. Kelly Armstrong today applauded President Donald Trump’s announcement of his plan to address the nation’s energy emergency with funding under the Defense Production Act, including up to $425 million for the U.S. Department of Energy for 12 projects selected to expand and reinvigorate America’s coal fleet and up to $75 million for a coal export facility.
The funding includes over $27.4 million to help pay for a $70 million proposed project to modernize two coal-fired units at North Dakota’s Antelope Valley Station, operated by Basin Electric Power Cooperative near Beulah in Mercer County. According to the DOE, the upgrades will mitigate unplanned outages, improve efficiency and increase generation capacity. The project is designed to ensure continued affordable and reliable electricity while also supporting local employment at Antelope Valley Station and Freedom Mine, the DOE said.
“North Dakota enjoys the lowest electricity rates in the nation, and investments like this will ensure our fleet of coal plants can produce clean, reliable and affordable power for decades to come,” Armstrong said. “We appreciate the continued support by President Trump and his administration for policies that support U.S. energy dominance and a more stable electric grid to serve our citizens, grow our economy and strengthen our national security. Coal country, and our entire state, will emerge even stronger from this action today.”
Prison Life in North Dakota
Every time we cross the Expressway overpass in Bismarck, you get a quick glimpse into prison life in North Dakota. Occasionally, you will see inmates in the yard doing various forms of outdoor recreation. The barbed wire that surrounds the North Dakota State Penitentiary is a sobering reminder that this is not where any sane person would ever want to spend any part of their life.
I met one of our listeners recently who works at the State Pen in Bismarck, and I got a chance to ask her some questions I’ve always wondered, mostly what life is like behind bars. “Is it like prison life in the movies?” She didn’t have a bright picture to paint, and that’s probably the way it should be, to help steer individuals away from a life of crime.
Oskari-Kauko Värä
I was surprised to find out that at least some of the inmates have tablets and are allowed to go online; their online experience is very controlled. I was also told prisoners are allowed to listen to the radio, something I already knew, as I have received calls from convicts making requests before. You kind of feel the pressure behind those requests, “play it or else”. Ha!
I plan to request a tour in the future using my media credentials and give you more insight into what it’s like behind bars at the North Dakota State Penitentiary.
Marina Nezhinkay
The 20 Worst Prisions in America
Did the North Dakota State Pen make the list? Nope. According to MoneyInc, these are the worst prisons that even the most hardened criminal would want to avoid.
20. Ely State Prison – Ely, Nevada
19. Folson State Prison – Folson, California
18. Penitentiary of New Mexico – Santa Fe, New Mexico
17. William C. Holman Correctional Facility – Atmore, Alabama
16. Sing Sing Correctional Facility – Ossining, New York
15. San Quentin State Prison – San Rafael, California
14. Louisiana State Pen – Angola, Louisiana
13. Rikers Island – New York, New York
12. Reeves County Detention Complex – Pecos, Texas
11. Julia Tutwiler Prison – Wetumpka, Alabama
10. Pelican Bay State Prison – Crescent City, California
9. United States Pen Marrion – Marion, Illinois
8. Idaho Correctional Center – Kuna, Idaho
7. United States Penitentiary Tucson – Tucson, Arizona
6. Leavenworth Federal Penitentiary – Leavenworth, Kansas
5. Orleans Parish Prison – New Orleans, Louisiana
4. Men’s Central Jail & Twin Towers Correctional Facility – Los Angeles, California
3. Tent City Jail – Phoenix, Arizona
2. Allan B. Polungky Unit – Livingtonston, Texas
1. US Penitentiary Administrative Maximum – Florence, Colorado
States with the most born-and-bred residents
Gallery Credit: Stacker
The 15 BEST Small-Town Cafes In North Dakota
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