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require the provision of medical billing information and a settlement offer for unpaid medical bills.

Before suing a patient for unpaid medical bills, healthcare providers must now provide patients with an itemized billing statement and a written settlement offer capped at 120% of the Medicare fee schedule, which the patient has 60 days to accept or reject. The settlement offer cannot be used as evidence in court if the case goes to trial. This gives patients a chance to resolve billing disputes without litigation and protects them from being sued for amounts exceeding standard Medicare rates.

provide protections for health care decisions governed by conscience.

This bill creates new protections that allow health care providers and institutions to refuse participation in medical services based on their ethical, moral, religious, or philosophical beliefs. It prohibits discrimination against providers who decline to participate in certain health care services for conscience-based reasons, and it shields them from adverse employment or administrative actions based on such refusals.

prohibit the cancellation or nonrenewal of a health insurance policy for a preexisting condition.

SB 129 prohibits health insurance companies in South Dakota from canceling or refusing to renew a person's health insurance policy based on a preexisting medical condition. This amends current state law to strengthen protections for individuals with existing health problems who might otherwise lose their coverage.

revise certain provisions regarding the use of telehealth technologies.

This bill updates South Dakota's definition of telehealth to clarify what technologies and delivery methods count as telehealth services—including video visits, audio with recorded information sharing, and remote monitoring of patients. The changes expand the types of electronic health services that health care providers can use while explicitly excluding basic phone calls, emails, and faxes from the definition of telehealth.

revise certain requirements for certain advisory committees under the Board of Medical and Osteopathic Examiners, Board of Nursing, and Board of Social Work Examiners.

HB 1048 revises the rules for advisory committees that help oversee physician assistants, nurses, and social workers in South Dakota. The bill updates membership requirements, term limits, and meeting standards for these advisory committees to ensure they operate more efficiently and with proper oversight.

accommodate legislation enhancing health and human services.

# HB 1193 Summary This bill establishes new rules for video monitoring in assisted living centers by defining key terms like "assisted living center" and "authorized representative" (including legal guardians and power-of-attorney agents). The legislation creates a framework requiring specific court authorization or documented consent before video monitoring can occur in these facilities.

revise provisions regarding autism spectrum disorder.

This bill updates South Dakota's insurance coverage rules for autism treatment by clarifying that autism spectrum disorder is defined using the latest diagnostic standards from the American Psychiatric Association's 2013 manual. The change ensures that insurance policies, contracts, and plans continue to cover applied behavior analysis (a recognized therapy) for people with autism spectrum disorders using the current medical definition.

require certain health care professionals to recommend treatments alternative to opioids.

Before prescribing opioids for pain, South Dakota health care professionals must recommend or offer alternative treatments such as physical therapy, occupational therapy, chiropractic care, massage therapy, acupuncture, or chronic pain management programs—based on what's clinically appropriate and available. The law doesn't require trying all alternatives first or prevent doctors from prescribing opioids alongside these other treatments.

require the costs of nursing homes to be rebased every five years for purposes of Medicaid reimbursement.

# HB 1239 Summary This bill requires South Dakota to recalculate what it reimburses nursing homes for Medicaid services every five years instead of using outdated cost figures, ensuring reimbursement rates better reflect current operating expenses. The bill updates the rules governing how nursing home costs are evaluated and removes outdated provisions that are no longer needed under the new rebasing system.

prohibit certain persons from practicing acupuncture.

This bill makes it illegal for anyone to practice acupuncture in South Dakota unless they are a licensed physician, osteopath, or chiropractor—violators face misdemeanor charges. The law defines acupuncture as inserting needles to treat pain or medical conditions based on oriental medicine, but excludes dry needling performed by physical therapists. The prohibition takes effect July 1, 2022.

provide for the licensure and regulation of practitioners of acupuncture and Oriental medicine and to establish the Acupuncture Licensing Board and acupuncture regulation fund.

South Dakota will establish a licensing system for acupuncture and Oriental medicine practitioners, creating a new Acupuncture Licensing Board to oversee their credentials and practice standards. The bill also creates a dedicated acupuncture regulation fund to support the board's operations. This brings acupuncture practitioners under state regulation for the first time, similar to how other healthcare professions like doctors and nurses are licensed.

revise certain provisions regarding marriage and family therapists.

This bill establishes new rules for marriage and family therapists in South Dakota by defining what the profession entails, requiring therapists to display their licenses prominently at their workplace, and making it a crime for unlicensed people to practice marriage and family therapy. The changes create clearer standards for who can legally practice this profession and help protect the public by ensuring only licensed professionals offer these services.

revise certain provisions regarding life and health insurance insolvencies.

This bill expands South Dakota's insurance protection fund to cover annuity policies and contracts in addition to existing life and health insurance coverage. The changes clarify that the state's insurance insolvency association—which protects policyholders when insurance companies fail—now explicitly safeguards people with annuities, and extends this protection to certain nonresident policyholders under specified conditions.

codify legislation enacted in 2019.

HB 1164 codifies (puts into permanent law) legislation that was enacted in 2019, making temporary or emergency measures from that year a permanent part of South Dakota law. The bill excerpt shows it includes new definitions and rules for assisted living centers and video monitoring of residents, establishing clearer legal standards for how these facilities operate. This ensures that important 2019 laws remain in effect going forward rather than expiring or remaining in temporary status.

create the medical reinsurance program and to make an appropriation therefor.

South Dakota is creating a new medical reinsurance program within the Division of Insurance to help pay for certain high-cost health insurance claims. The program will be funded through assessments on health insurers based on their premium earnings, and will reimburse insurers for claims that exceed a set dollar threshold per individual in a benefit year.

revise provisions regarding replacement nursing facilities.

South Dakota currently prohibits new nursing facilities unless they replace existing ones and meet strict requirements like eliminating safety hazards or complying with state standards. This bill expands those allowable reasons to include improving operations, increasing services, and consolidating with other health care providers. The bill makes it easier for nursing facilities to build replacements by adding these new justifications to the existing list of approved reasons.

provide for step therapy protocol regarding certain prescription drugs.

SB 155 adds new rules about "step therapy" — a practice where insurance companies require patients to try cheaper or less intensive drugs first before approving coverage for other medications. The bill amends South Dakota's health insurance regulations to establish a formal protocol for when and how insurers can impose these step therapy requirements on prescription drugs.

revise provisions regarding health benefit plans.

SB 181 modifies the rules governing health benefit plans under South Dakota law, though the specific details of these changes are not fully visible in the provided text excerpt. To give you an accurate summary of what this bill actually changes for health insurance plans and their coverage or administration, I would need to see the complete text of the amendments to §10-56-22.

authorize video monitoring of residents in assisted living centers and nursing facilities.

This bill allows residents of assisted living centers and nursing facilities—or their spouses, guardians, or attorneys-in-fact—to install video cameras in their own rooms to record what happens there. Before installing a camera, the resident or their representative must notify the facility in writing using a form created by the Department of Health.

revise certain provisions regarding the practice of a certified registered nurse anesthetist.

This bill expands the scope of practice for certified registered nurse anesthetists (CRNAs) in South Dakota by adding new specific duties they can perform, including conducting advanced patient assessments, ordering and interpreting diagnostic tests, prescribing medications (including controlled substances), and making patient referrals to other healthcare providers. The bill also reorganizes and updates the list of anesthesia-related functions CRNAs may perform while working under physician supervision. These changes give CRNAs broader authority to independently manage certain aspects of anesthesia care beyond their previous responsibilities.

require a feasibility study and actuarial analysis on long-term care services and supports.

The Department of Labor and Regulation must hire an independent company to study whether South Dakota should create a new long-term care insurance program and, if so, what type would work best. The study will examine affordable options that help people pay for services like nursing care or assisted living, look at gaps in current coverage, and estimate how many people would participate and what it would cost the state.

revise certain provisions regarding private placement insurance.

This bill modifies how insurance companies must pay death benefit claims on private placement insurance policies. Instead of requiring payment within two months, insurers can now delay payment if the policy is tied to separate investment accounts that aren't liquid, allowing them to pay out the benefits only when those assets can be converted to cash or distributed according to their terms. The company must verify the fair market value of any assets distributed directly to the beneficiary.