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HB 1283

relative to the use of face recognition technology.

2026 Regular Session Introduced by Dan McGuire and 1 co-sponsor

Eliminates out-of-pocket costs for diagnostic and supplemental breast exams in the state health plan, with an HDHP/HSA exception; sunset 2027 and PERS reports on extension.

Inexpedient to Legislate: MA VV 03/05/2026 HJ 6 P. 24
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Bill Summary · HB 1283

HB 1283 — Diagnostic and Supplemental Breast Examination Cost‑Sharing Restrictions (North Dakota)

Status: Second reading — failed to pass (yeas 22, nays 24)
Introduced: November 13, 2024
Citation: Creates a new section in chapter 54‑52.1, North Dakota Century Code

Purpose / Intent

To eliminate out‑of‑pocket cost‑sharing (deductibles, copayments, coinsurance, or similar charges) for medically necessary diagnostic and certain supplemental breast examinations under the health benefits plan administered by the board, and to require the Public Employees Retirement System (PERS) to report on the policy’s effects and recommend whether to extend the restriction more broadly.

Key provisions

  • Definitions:
    • “Diagnostic breast examination” — medically necessary exams used to evaluate an abnormality (examples listed: contrast‑enhanced mammography, diagnostic mammography, breast MRI, breast ultrasound).
    • “Supplemental breast examination” — medically necessary screening exams (same modalities) used when no abnormality is present but screening is warranted by personal/family medical history or other elevated risk factors.
  • Cost‑sharing prohibition:
    • Health benefits coverage provided by the board may not impose any deductible, copayment, coinsurance, or other cost‑sharing that results in out‑of‑pocket costs for diagnostic or supplemental breast examinations (subject to the HDHP/HSA exception below).
  • HDHP / HSA exception:
    • If applying the prohibition would cause a plan to lose qualification as a high‑deductible health plan (HDHP) eligible for a health savings account (HSA) under 26 U.S.C. §223, then the prohibition does not apply to the plan’s deductible until the enrollee meets the statutory minimum HDHP deductible. An exception remains for preventive services as defined in §223(c)(2)(C) — those remain covered without cost‑sharing regardless of deductible status.
  • Reporting and possible extension:
    • PERS must prepare a bill for the next (seventieth) legislative assembly to repeal this Act’s expiration and extend the cost‑sharing restriction to all group and individual health insurance policies. That submission must include a report on the effect of the restriction on PERS’s health plans, utilization and costs, and a recommendation on continuation.
  • Application and expiration:
    • Applies to health benefits coverage that begins after June 30, 2025 and does not extend past June 30, 2027.
    • The Act expires and is ineffective after June 30, 2027.

Who is affected

  • Primary: enrollees in the board’s health benefits plan (state/public employees covered under chapter 54‑52.1).
  • Potentially affected: if PERS’ follow‑up bill is enacted, all group and individual health insurance policies in the state.
  • Insurers and the state plan: may experience increased utilization and costs for the covered exams; HDHP issuers must consider HSA compliance.

Fiscal and practical impact

  • Direct fiscal impacts are not specified in the text. Removing cost‑sharing is likely to increase utilization and raise plan expenditures for the covered diagnostic and supplemental services; how large those increases would be is to be documented in the PERS report.
  • The HDHP exception preserves HSA eligibility but may limit immediate scope for some consumer plans.
  • The statutory sunset (June 30, 2027) and required PERS report create a near‑term review process before any permanent or broader change.

Procedural / Timeline notes

  • Coverage changes would take effect for plans beginning after June 30, 2025.
  • The bill as drafted is temporary (through June 30, 2027); PERS must submit legislative recommendations and a report to the next legislative assembly if continuation/expansion is desired.

Compiled from official sources — confirm details with the bill’s official record.

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