1.1
North Dakota Medicaid.
Notice: Starting in 2026, some people’s Medicaid eligibility will change. Visit ourStay Enrolled webpageto learn more!
Why It Matters
Sources:Source
Welcome to your daily briefing on healthcare developments in North Dakota. Today we're covering 5 key stories including updates on north dakota healthcare headlines, background & context. Let's dive in.
1
North Dakota Healthcare Headlines
2 stories
1.2
National Provider Identifier (NPI) Information for ND Healthcare Providers.
The CMS-10114 National Provider Identifier (NPI) Application/Update Form is now available.
Why It Matters
This form is essential for healthcare professionals in ND to ensure proper enrollment and identification in the Medicaid system.
Sources:Source
Sponsored
Advertise Here
Reach healthcare professionals
2
Background & Context
3 stories
2.1
Why prior-auth denials cluster around the same five reasons.
Across most payors, the top-five denial reasons account for over 80% of prior-auth rejections: missing clinical documentation, wrong CPT/HCPCS code, service not in benefit plan, step-therapy not completed, and ordering provider not on the patient's plan. The same five repeat across plans because they are the easiest to deny on automation.
Why It Matters
Practices that build a five-line pre-submission checklist around these reasons typically cut prior-auth denials by 40-60% within a quarter. The fix is process, not appeals capacity.
2.2
340B recertification: the most-missed deadline in pharmacy compliance.
Covered entities must annually recertify their 340B eligibility through HRSA. Missing the recertification window pushes the entity to inactive status, which means immediate loss of 340B pricing and potentially diversion violations on previously dispensed drugs. Reinstatement requires a new application.
Why It Matters
The discount value of 340B pricing for a covered entity often exceeds six figures annually. Letting the recertification lapse for paperwork reasons is one of the most expensive administrative errors in the regulation.
2.3
Good Faith Estimates apply to far more practices than you think.
The No Surprises Act good-faith-estimate requirement applies to all licensed providers offering services to self-pay or uninsured patients — not just hospitals or large groups. The estimate must be provided within timeframes that vary by how far in advance the appointment is scheduled.
Why It Matters
Patient-provider dispute resolution under NSA typically defaults to the patient when the practice cannot produce a timely good-faith estimate. The penalty is the full disputed amount being struck.
Never Miss an Update
Get North Dakota healthcare intelligence delivered to your inbox every morning.
Subscribe FreeIssue Summary
DateMay 13, 2026
Stories5
Sections2
Read Time2 min
Browse Archive
View all past issues
National Partner
Reach Professionals Nationwide
Feature your brand across the U.S., Canada, and select international markets and 10 industry verticals.
Become a National Partner