North Dakota Contract for Care, documented as a workers’ compensation coverage condition

Status: North Dakota evidence build reviewed through October 4, 2026. North Dakota is materially different from states where medical licensing rules impose a treatment agreement on chronic-pain patients generally.

The controlling Contract-for-Care requirement

N.D.C.C. §65-05-39 requires a treatment agreement as a condition of Workforce Safety & Insurance payment for chronic opioid therapy in covered workers’ compensation claims. Chronic opioid therapy is defined as opioid treatment extending beyond 90 days for pain from a nonmalignant compensable condition or therapy for another nonterminal compensable condition.

WSI requirement What North Dakota requires for coverage
Treatment agreement The prescriber must provide WSI an agreement between the injured employee and prescriber.
Single prescriber The agreement must restrict treatment access and limit prescriptions to one identified prescriber, with limited same-clinic coverage and specialist-referral exceptions.
Effectiveness documentation At least every 90 days.
Functional/clinical benefit Therapy must improve function, enable return to work, or improve pain control without debilitating side effects.
Non-opioid treatment The injured employee must have been nonresponsive to non-opioid treatment.
Substance condition The injured employee must not be using illegal substances or abusing alcohol.
Random drug testing The prescriber or WSI may request testing for prescribed and illicit substances.
Coverage consequence Test failure, untimely compliance, or failure to meet statutory conditions may result in termination of chronic-opioid coverage.

This is not a universal North Dakota physician contract mandate

North Dakota’s separate physician pain-treatment statute, Chapter 19-03.3, authorizes physicians to prescribe controlled substances for pain for medically accepted therapeutic purposes and protects such treatment from certain hospital restrictions and Board discipline. That chapter contains no WSI-style treatment-agreement requirement.

North Dakota state records

Legislative origin

The agreement requirement was enacted in 2015 through Senate Bill 2060 after a workers’ compensation performance review recommended a pain-contract and drug-screening system for long-term opioid claims. WSI’s current public policy continues to implement the statute.

Separate WSI payment limits

Section 65-05-40 adds independent workers’ compensation payment limits involving opioid dose, initial outpatient supply, benzodiazepine duration, and concurrent opioid-benzodiazepine therapy. Those limits are related to WSI opioid control but are not clauses of the §65-05-39 treatment agreement.

Practice-evidence gap

The current public record establishes the statutory agreement requirement and WSI policy clearly, but a current public WSI agreement template was not located. This library will not invent the form’s wording from the statute. The North Dakota submission page is designed to collect actual blank WSI-linked agreements, clinic forms, and coverage notices.

Formal change route

Because the core agreement requirement is written directly into §65-05-39, removing it requires legislative amendment. WSI may separately revise implementation policy and administrative rules within statutory authority. Current WSI Director Art Thompson administers the agency, while the North Dakota Legislative Assembly controls the statutory mandate.

Submit a North Dakota agreement or WSI notice

Submit a North Dakota Contract for Care

Primary authorities

Reviewed: October 4, 2026.

Evidence boundary: North Dakota’s Contract-for-Care requirement documented here is a workers’ compensation payment condition. It should not be represented as a universal agreement requirement for all North Dakota pain patients.