69th Legislative Interim - Health Care Committee [Source] Translate

The Interim Health Committee meeting began with roll call and confirmation of a quorum. Chair Van Oosting led the meeting in the absence of Chair McLeod, who was recovering from surgery. The minutes from the previous meeting were approved. Megan Ruby presented the Historical Healthcare Mandates Memorandum, which analyzed current health care mandates as directed by Senate Bill 2249. She explained that state health insurance mandates apply only to certain state-regulated health plans, while self-insured plans are governed by federal law. The memorandum outlined procedural requirements for proposed mandates, including the necessity of a cost-benefit analysis. Ruby provided a historical overview of amendments to the North Dakota Century Code regarding health insurance mandates, particularly Section 5403-28, and discussed essential health benefits defined by the Affordable Care Act. She categorized existing mandates and summarized their enactment dates and requirements. Senator Lee inquired about pharmacy selection limitations, and Ruby clarified that North Dakota has an "any willing pharmacy" law. The discussion emphasized the implications of health insurance mandates on affordability and access to care, highlighting the need for regular reviews of mandates to ensure they align with advancements in medical science. Examples of outdated requirements were provided, and the importance of aligning mandates with evidence-based standards was stressed. The meeting also addressed the rising costs of health care, with statistics indicating that a significant portion of employers' costs is passed on to employees. Concerns were raised about the implications of repealing mandates and the potential for patients to forego care. The need for periodic reviews of mandates was highlighted, as well as the complexities of self-funded plans and the lack of awareness among employees regarding their coverage. Dylan Wheeler from Sanford Health Plan discussed the definition of mandates and proposed creating a standard presumption of coverage mandates to streamline the process. The meeting focused on the private health insurance market in North Dakota, emphasizing the importance of understanding the source of health issues when considering legislation. The legislative process for health insurance mandates was discussed, including the procedures for submitting proposals and the implications of those mandates on costs and coverage. A pilot program through the Public Employees Retirement System (PERS) was established to evaluate mandated coverage effects, with only two mandates having completed the pilot process. The meeting also touched on the complexities of defining mandates and the need for clarity in the legislative process. The discussion included the rising number of proposed measures impacting the health insurance market and the importance of thorough analysis and communication. The implications of mandates in the insurance industry were further explored, with a focus on the Affordable Care Act's benchmark plan and the necessity for state funding for new benefit mandates. Nathan from Essentia Health emphasized the need for collaboration to address rising healthcare costs. The meeting concluded with discussions on off-label drug use, Medicaid regulations, and the challenges faced in navigating the legislative process for breast cancer screening mandates. The committee also discussed dental education and workforce considerations for establishing a dental school in North Dakota, highlighting the shortage of dentists and the need for better access to dental services. The meeting wrapped up with a focus on Medicaid dental services, comparing North Dakota's program with neighboring states and addressing barriers to provider enrollment. The need for improvements in dental service access and policy clarity was emphasized, along with ongoing communication with dental providers. Prior authorization processes for dental services were reviewed, noting changes that aim to reduce administrative burdens. The meeting concluded with a discussion on electronic prior authorization submissions and the barriers faced by providers, particularly in rural areas. The next meeting is tentatively scheduled for the end of May.