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Legislation Signed into Law

2015

SB 2046
Introduced: 1/2015
Sponsor: Human Services Committee
Status: Signed into law 4/2015
Summary: This bill changed the state public welfare law so that the state Medicaid program will now cover some behavioral health services provided by licensed marriage and family therapists.

2005

Primary Focus: Mandated Benefits: Mental Health
Title/Description: Group health policy and health service contract mental disorder coverage
Citation: N.D. Cent. Code, § 26.1-36-09
Summary: An insurance company, nonprofit health service corporation, or health maintenance organization may not deliver, issue, execute, or renew any health insurance policy or health service contract on a group or blanket or franchise or association basis unless the policy or contract provides benefits, of the same type offered under the policy or contract for other illnesses, for health services related to the diagnosis, evaluation, and treatment of mental disorder and other related illnesses. The benefits must be provided for each of the following services: inpatient treatment, treatment by partial hospitalization, residential treatment, and outpatient treatment.
In the case of benefits provided for inpatient treatment, the benefits must be provided for a minimum of 45 days of services. For partial hospitalization, the benefits must be provided for a minimum of 120 days of services. In the case of benefits provided for residential treatment, the benefits must likewise be provided for a minimum of 120 days of services. However, any individual receiving residential treatment services who requires residential treatment service beyond the minimum of one hundred twenty days may trade unused inpatient treatment benefits
Effective Date: Amended March 15, 2005.
Notes: N/A

Primary Focus: Mandated Benefits: SUD
Title/Description: Group health policy and health service contract substance abuse coverage.
Citation: N.D. Cent. Code, § 26.1-36-08
Summary: An insurance company, nonprofit health service corporation, or health maintenance organization may not issue any health insurance policy or health service contract on a group, blanket, franchise, or association basis unless the policy or contract provides benefits of the same type offered under the policy or contract for other illnesses, for health services related to the diagnosis, evaluation, and treatment of alcoholism, drug addiction, or other related illnesses.
The benefits must be provided for inpatient treatment, treatment by partial hospitalization, and outpatient treatment.
For benefits provided for inpatient treatment, the benefits must be provided for a minimum of sixty days. For benefits provided for partial hospitalization, the benefits must be provided for a minimum of one hundred twenty days of service per year. Benefits may also be provided for a combination of inpatient and partial hospitalization treatment.
In the case of benefits provided for outpatient treatment, the benefits must be provided for a minimum of twenty visits for services. Deductibles and copays are prohibited for the first five visits in any calendar year, and the copayment may not be greater than 20% for the remaining visits.
Effective Date: Amended March 15, 2005
Notes: As an alternative to the substance abuse coverage described above, an insurance company, a nonprofit health service corporation, or a health maintenance organization may provide substance abuse coverage under N.D. Cent. Code, § 26.1-36-08.1.

2003

Primary Focus: Mandated Benefits: SUD
Title/Description: Alternative group health policy and health service contract substance abuse coverage.
Citation: N.D. Cent. Code, § 26.1-36-08.1
Summary: An insurance company, a nonprofit health service corporation, or a health maintenance organization may, in the alternate, provide substance abuse coverage under this section.
In addition to the inpatient treatment, treatment by partial hospitalization and outpatient treatment coverage required under N.D. Cent. Code, § 26.1-36-08, the coverage under this section must include coverage for residential treatment. Benefits for residential treatment must be provided for a minimum of 60 days. However, if the individual requires more than 60 days of treatment, unused inpatient treatment benefits may be traded for residential treatment benefits. For coverage of inpatient treatment, the benefits must be provided for a minimum of 45 days.
Effective Date: April 8, 2003
Notes: N/A

North Dakota Parity Law

There are two sections of the state insurance law relevant to parity. There is a section about mental health coverage (26.1-36-9), and there is a section about substance use disorder coverage (26.1-36-8).

It is not possible to link directly to these sections. To find them click here (pdf | Get Adobe® Reader®) and scroll to the respective sections.

Mental Health Coverage

Large employer fully-insured plans and small employer fully-insured plans must cover mental health services. This section requires plans to cover the following each year:

Substance Use Disorder Coverage

Large employer fully-insured plans and small employer fully-insured plans must cover substance use disorder services. This section requires plans to cover the following each year:

Plans can choose to provide coverage for residential treatment, but if they do, they must cover at least 60 days. However, if they cover residential treatment they can then reduce their coverage of inpatient care to 45 days, but they must allow patients to exchange up to 23 days of inpatient care for an additional 46 days of residential treatment.

Get Support

North Dakota Insurance Division

Common Violations

In seeking care or services, be aware of the common ways parity rights can be violated.

Common Violations

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