Overview
South Dakota has been active in regulating prescription drug pricing and transparency. The state enacted a law to prohibit pharmacy benefit managers from prohibiting or penalizing a pharmacist for providing cost-sharing information on the amount a covered individual may pay for a particular prescription drug. The legislature also passed legislation that 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.).
In healthcare markets, the state’s antitrust legislation provides that nonprofit hospitals must provide notice to the state attorney general for any mergers, acquisitions, or related transactions. The state also limits the duration of noncompete clauses in physician employment contracts to two years after the date of termination and within a specified geographic area. South Dakota also promotes telemedicine with mandated coverage parity and cost-sharing parity for telehealth services.
See below for an overview of existing South Dakota state mandates. Click on citation tab for detailed information of specific statutes (click link to download statute text).
State Action
Latest Legislative Session: 1/10/2023 - 3/27/2023 (2023 term). *Current session bill updates are ongoing. Check back weekly for updates.
HB 1003 – South Dakota
Introduced: 2021 Status: Enacted
An act to revise certain provisions regarding credit for reinsurance. Credit must be allowed when the reinsurance is ceded to an assuming insurer with its head office or domicile in a reciprocal jurisdiction.
HB 1005 – South Dakota
Introduced: 2020 Status: Enacted
An Act to revise certain provisions regarding the use of telehealth technologies.
HB 1017 – South Dakota
Introduced: 2020 Status: Enacted
An Act to provide for certain insurer corporate governance disclosure requirements.
HB 1029 – South Dakota
Introduced: 2022 Status: Inactive / Dead
An Act to revise the definition of telehealth for purposes of health insurance policies.
HB 1087 – South Dakota
Introduced: 2023 Status: Inactive / Dead
Prohibit restrictive employment contracts for health care workers
S.D. Codified Laws § 58-17H-21. Data systems to support program activities and generate management reports: Utilization Review and Benefit Determinations – South Dakota
Introduced: Status: Enacted
Any health carrier’s data system shall be sufficient to support utilization review program activities and to generate management reports to enable the health carrier to monitor and manage health care services effectively.
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S.D. Codified Laws § 58-17H-27. Written procedures required for making determinations–Notification: Utilization Review and Benefit Determinations – South Dakota
Introduced: Status: Enacted
A health carrier shall maintain written procedures pursuant to this chapter, for making standard utilization review and benefit determinations on requests submitted to the health carrier by covered persons or their authorized representatives for benefits …
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S.D. Codified Laws § 58-17H-28. Prospective review determinations–Timing–Notification of requirements–Extension of time: Utilization Review and Benefit Determinations – South Dakota
Introduced: Status: Enacted
For any prospective review determination, other than allowed by this section, a health carrier shall make the determination and notify the covered person or, if applicable, the covered person’s authorized representative of the determination, whether …
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S.D. Codified Laws § 58-17H-29. Concurrent review determinations–Timing–Notification requirements: Utilization Review and Benefit Determinations – South Dakota
Introduced: Status: Enacted
The health care service or treatment that is the subject of the adverse determination shall be continued without liability to the covered person until the covered person has been notified of the determination by the …
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S.D. Codified Laws § 58-17H-30. Retrospective review determinations–Timing–Notification requirements: Utilization Review and Benefit Determinations – South Dakota
Introduced: Status: Enacted
For retrospective review determinations, the health carrier shall make the determination within a reasonable period of time, but in no event later than thirty days after the date of receiving the benefit request.
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In re: Suboxone Antitrust Litigation (State of Wisconsin, et al. v. Indivior Inc, et al.) – Alabama, Alaska, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Utah, Virginia, Washington, West Virginia, Wisconsin
District Court: E.D. Pennsylvania Status: Pending
In September 2016, 35 state attorneys general and the District of Columbia brought a multi-district case against pharmaceutical manufacturer Indivior, MonoSol RX et al., alleging …
Additional Resources
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.
STATE LEGISLATURE
The South Dakota Legislature begins its session on the second Tuesday of January, lasting 40 working days in odd-numbered years, and 35 days working days in even numbered years. The state has 35 Senators, and 70 members of the House of Representatives. Both Senators and Representatives are elected to 2-year terms, and are limited to serving four consecutive 2-year terms in a particular chamber, but there is no limit on the number of non-consecutive terms. Bills do not carry over from year to year.