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.).

State Action




2020 Legislative Session: 1/14/2020 - 3/30/2020 (2020 term). *Current session bill updates are ongoing. Check back weekly for updates.

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© 2018-2019 The SLIHCQ DatabaseInitial 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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© 2018-2019 The SLIHCQ DatabaseInitial 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

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.

STATE BUDGET

South Dakota operates on an annual budget cycle. The governor submits a proposed budget in December and the legislature typically adopts a budget in March. The fiscal year runs from July 1 through June 30 and is referred to by the year in which it ends.

KEY RESOURCES