North Dakota Code § 54-03-28

Health insurance mandated coverage of services - Cost -benefit analysis
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requirement.
1. The legislative management shall adopt a procedure for identifying measures and 
proposed measures mandating health insurance coverage of services or payment for 
specified providers of services. The procedure must include solicitation of draft 
measures and proposals during the interim between legislative sessions from 
legislators and agencies with bill introduction privileges and must include deadlines for 
identification of the measures or proposals.
2. Except as provided in subsection 3, a committee of the legislative assembly may not 
act on a legislative measure the legislative management or committee determines 

mandates health insurance coverage of services or payment for specified providers of 
services unless the measure as recommended by the committee provides:
a. The measure is effective through June thirtieth of the next odd -numbered year 
following the year in which the legislative assembly enacted the measure, and 
after that date the measure is ineffective.
b. The application of the mandate is limited to the public employees health 
insurance program and the public employee retiree health insurance program. 
The application of the mandate begins with every contract for health insurance 
which becomes effective after June thirtieth of the year in which the measure 
becomes effective.
c. That for the next legislative assembly, the public employees retirement system 
shall provide to the employee benefits programs committee a report regarding the 
effect of the mandated coverage or payment on the system's health insurance 
programs. The report must include information on the utilization and costs relating 
to the mandated coverage or payment and a recommendation on whether the 
coverage or payment should continue for the system's health insurance 
programs.
3. If the legislative management determines a legislative measure mandating health 
insurance coverage of services or payment for specified providers of services has 
completed the process under subsection 2, the measure may not be referred to a 
committee of the legislative assembly unless a cost-benefit analysis provided by the 
legislative management is appended to the measure.
a. If a committee of the legislative assembly determines a measure or a proposed 
amendment to the measure mandating health insurance coverage of services or 
payment of specified providers of services was referred to committee without a 
cost-benefit analysis, the committee shall request the legislative management 
provide a cost-benefit analysis.
b. The committee may not act on the measure unless the measure is accompanied 
by the cost-benefit analysis.
4. Factors considered in the cost-benefit analysis must include:
a. The extent to which the proposed mandate would increase or decrease the cost 
of the service.
b. The extent to which the proposed mandate would increase the appropriate use of 
the service.
c. The extent to which the proposed mandate would increase or decrease the 
administrative expenses of insurers and the premium and administrative 
expenses of insureds.
d. The impact of the proposed mandate on the total cost of health care.
5. The legislative council shall contract with a private entity to provide the legislative 
management the cost-benefit analysis required by this section.

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