ND Healthcare AI Act
North Dakota Prior Authorization and Healthcare AI Act (SB 2280)
Regulates AI use in healthcare prior authorization decisions. Requires adverse determinations be reviewed by licensed physicians qualified in relevant specialty. Sets decision timelines: 7 days for non-urgent, 72 hours for urgent services. Prohibits prior authorization for emergency services and opioid use disorder treatment.
Jurisdiction
North Dakota
Enacted
Apr 23, 2025
Effective
Jan 1, 2026
Enforcement
North Dakota Insurance Commissioner
Signed by Governor Armstrong April 23, 2025
North Dakota LegislatureWhy It Matters
Mandates human-in-the-loop for healthcare AI decisions. Protects opioid use disorder treatment from AI denials. Model for healthcare AI accountability.
Recent Developments
First state law specifically requiring human physician review of AI healthcare decisions. Addresses growing concern about AI in prior authorization denials.
At a Glance
Applies to
Requires
Who Must Comply
- Health insurers operating in North Dakota
- Prior authorization review organizations
- AI systems used in healthcare coverage decisions
Obligations fall on:
Safety Provisions
- Licensed physician/dentist review required for adverse AI determinations
- Reviewing physician must be qualified in relevant medical specialty
- 7-day decision timeline for non-urgent services
- 72-hour decision timeline for urgent services
- Prior authorization prohibited for emergency medical services
- Prior authorization prohibited for medication-assisted treatment for opioid use disorder
- Approved authorizations valid for at least 6 months
Compliance & Enforcement
Key Dates
Jan 1, 2026
All provisions take effect
Penalties
Administrative enforcement through Insurance Commissioner oversight.
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North Dakota
Focus Areas
Cite This
APA
North Dakota. (2025). North Dakota Prior Authorization and Healthcare AI Act (SB 2280).
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Last updated January 27, 2026. Verify against primary sources before relying on this information.