North Dakota Medicaid Expansion
This page is for providers in the North Dakota Medicaid Expansion Program, administered by Sanford Health Plan.
ND DHS manages the application and eligibility determination process, as well as administration of retail outpatient pharmacy benefits. If you have questions about pharmacy benefits or covered drugs, please call ND DHS at (800) 755-2604 | TTY: 711.
Sanford Health Plan manages the following services: medical management, customer service, claims, provider relations and medical provider network.
The State of North Dakota’s Traditional Medicaid program and the program administered by Sanford Health Plan, known as North Dakota Medicaid Expansion (NDME), operate under different systems. Please note Medicaid Expansion benefits through Sanford Health Plan are different from traditional Medicaid services provided by the state of North Dakota.
Announcements
- COVID-19 Vaccine Guidance from SHP to Pharmacies
- Filling a CMS 1500 Claim for Vaccine Administration as a Medical Claim
- Sanford Health Plan Provider Fact Sheet for NDME 1915i
- NDME Taxonomy and Enrollment Requirements
Member Documents
- Appeal Rights & Filing Form
- Certificate of Insurance
- Member Handbook
- Summary of Benefits and Coverage (SBC for all NDME Members)
- Member Travel, Lodging and Meal Guide
Provider Forms
- HHS-687 Consent for Sterilization Form
- Transition of Care Form
- Medicaid Expansion Lock-In (CSP) Program Form
Links
Apply for Coverage: For detailed information on the North Dakota Medicaid Expansion Program, including how to apply for coverage, visit the North Dakota Medical Services website or call (844) 854-4825 (toll-free).
Provider Network: Select the “Individual – ND Medicaid Expansion” network from the dropdown menu