SOUTH DAKOTA

Overview

In the most recent legislative term, South Dakota passed SB 141, which prohibits a pharmacy benefits manager from prohibiting or penalizing a pharmacist for providing cost-sharing information on the amount a covered individual may pay for a particular prescription drug. Also in 2018, South Dakota sought to expand coverage by introducing two bills that would provide for the utilization and regulation of telemedicine in their state, though both of those bills were tabled at the end of the session.

In the 2015-2016 legislative term, South Dakota passed SB 118 to regulate healthcare price transparency. The legislation requires health carriers to provide prospective enrollees with drug formularies and detailed plan descriptions that explain plan coverage limitations and their financial impact on enrollees (e.g., co-insurances, out-of-pocket expenses, etc.).

The State Database

The Source tracks state activities impacting healthcare price and competition in both legislation and litigation in a searchable database to help stakeholders at the state level understand their legal and regulatory environment as they make efforts to improve access, quality, and efficiency, and reduce costs in healthcare.

LEGISLATION: The Database of State Laws Impacting Healthcare Cost and Quality (SLIHCQ), created by The Source on Healthcare Price & Competition and Catalyst for Payment Reform, catalogues state legislation governing price transparency, provider market power, provider payment, provider networks, and benefit design. The database also includes pharmaceutical legislation beginning in the 2017-2018 legislative session. *Note: Current legislative session bill updates are ongoing. Check back weekly for updates. 

LITIGATION: The Source tracks major litigation and antitrust enforcement action by federal entities (FTC or DOJ), state attorney generals, and private parties in the main provider and insurer markets, particularly legal challenges of healthcare consolidation and anticompetitive contract provisions. Additionally, the database contains major pharmaceutical cases including legislation challenges and significant appellate cases.

Search the database across all jurisdictions on the State Overview page, or view and filter existing legislation or litigation on individual state pages. The database allows customized search and filter by keyword, status, and/or key issue category. *Multiple filter/selections enabled. Click here for User Guide.

 

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© 2018-2019 The SLIHCQ Database. Initial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.
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Download User Guide
© 2018-2019 The SLIHCQ Database. Initial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.
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Additional Resources

LEGISLATIVE CALENDAR

South Dakota’s current legislative term runs from 1/8/2019 – 3/29/2019. South Dakota’s next legislative term will begin in 2020.

BALLOT MEASURES

  • Voters in the November 2014 election cycle approved Initiated Measure 17 with a 62-38 percent margin, adopting an Any Willing Provider (AWP) statute which states that no health insurer may exclude a healthcare provider from participating in the insurers panel of providers if the provider is located within the geographic coverage of the benefit plan and is willing and qualified to meet the terms and conditions of participation as established by the provider.
  • Initiated Measure 17 was opposed by health insurers because they claim it prevents carriers from controlling costs by negotiating volume discounts with providers. Insurers are also concerned that opening their networks to physician-owned specialty hospitals may incentivize cream skimming and disrupt the narrow-network trend, which otherwise allows insurers to control cost growth by excluding certain providers on the basis of their overall cost. Advocates of the measure assert that the law will protect consumer choice by allowing more providers into benefit plan panels.

FY 2018 BUDGET

South Dakota’s fiscal year runs from July 1 through June 30 and is referred to by the year in which it ends. The South Dakota Legislature enacted the FY 2018 Budget in the 2017 regular legislative session. To view South Dakota’s Department of Health FY 2018 spending plan, visit pages 26-29.

KEY RESOURCES

 

Coverage

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