N.D. Cent. Code § 43-28-28 (2025)
1. As authorized under this section, a dental provider and a dental insurer may enter into voluntary non-fee-related joint negotiations. Before commencing voluntary joint negotiations, a joint negotiation representative shall notify the attorney general of its intent to engage in voluntary joint negotiations. The notice must be in writing and include: a. The matters, including terms and conditions, to be negotiated; b. The identity and location of all dental providers participating in the voluntary joint negotiations; c. The identity, location, and market share of the dental insurer the dental providers seek to engage in voluntary joint negotiations; d. A statement explaining the circumstances create the need for voluntary joint negotiations and the benefits anticipated from the voluntary joint negotiations; and e. The joint negotiation representative's procedures to ensure compliance with this section.
2. At the time of the filing with the attorney general, the joint negotiation representative shall provide a copy to the dental insurer of its notice and any other materials submitted to the attorney general. The dental insurer may provide additional information to the attorney general regarding matters described in this section.
3. The attorney general shall review the notice to determine whether the proposed voluntary joint negotiations comply with law and public policy, and shall, within ninety days, unless a thirty day extension is approved by the parties, notify the joint negotiation representative and the dental insurer whether voluntary joint negotiations are authorized under this section. The attorney general, in determining whether voluntary joint negotiations are authorized, shall consider the following factors: a. The stated necessity and anticipated benefits of voluntary joint negotiations; b. The market and bargaining power of the parties; c. A party's ability to control or steer consumers, dictate terms of contracts, impose final or nonnegotiable terms, or dictate or limit products or services available or offered to consumers; d. The contract terms to be negotiated, and the contract terms' potential effect on the ability to provide quality care or medically appropriate care without delay and difficulty; e. The risk of anticompetitive effects; and f. The potential effect on price, quality, choice, or access to products or services for consumers or others.
4. The attorney general may request additional information from the parties at any point during the process or during the parties' negotiations.
5. Upon a determination by the attorney general that voluntary joint negotiation is authorized under this section, and after a duly authorized officer of the dental insurer and all dental providers seeking voluntary joint negotiations have granted written consent, two or more dental providers practicing in the service area of the dental insurer may jointly engage in voluntary negotiations with the dental insurer regarding the following non-fee-related matters: a. Definition of medical necessity and other conditions of coverage. b. Utilization management criteria and procedures. c. Clinical practice guidelines. d. Preventative care and other medical management policies. e. Patient referral standards and procedures. f. Drug formularies and standards for prescribing off-formulary drugs. g. Quality assurance programs. h. Liability terms for a dental provider and dental insurer. i. Administrative procedures. j. Credentialing standards and procedures for selection, retention, and termination of participating dentists.
12. This section may not be construed to: a. Permit a coordinated cessation, reduction, or limitation of dental services. b. Affect government approval of, or otherwise restrict activity by, dental providers which is not prohibited under federal antitrust law or require approval or contract terms to the extent the terms are exempt from state regulation under federal law.