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.
2 stories
Starting in 2026, Medicaid eligibility will change for some North Dakota residents.
Healthcare professionals in ND should anticipate how these eligibility shifts may affect patient coverage and clinic workflows.
The CMS-10114 National Provider Identifier (NPI) Application/Update Form is available for provider use.
Healthcare professionals in ND need this form to apply for or update their NPI, which is essential for Medicaid enrollment and billing operations.
Reach healthcare professionals
3 stories
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.
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.
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.
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.
Three application defects routinely delay payor enrollment: incomplete work-history explanations for any gap over 30 days, a malpractice carrier-history that does not reconcile with the explanation, and CAQH attestation that has lapsed. Each forces a back-and-forth with the credentialing committee.
A new clinician without active payor enrollment cannot bill for covered services for most plans. Each month of delay is foregone revenue that does not retroactively recover.
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