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revise the definition of bona fide practitioner-patient relationship in relation to medical cannabis.

HB1147 updates South Dakota's medical cannabis law to clarify what counts as a legitimate doctor-patient relationship for cannabis recommendations. The bill specifies that a valid relationship requires the doctor to have examined the patient's medical history and current condition (either in person or via telehealth), discussed the patient's qualifying medical condition, and be available for follow-up care.

provide for the protection of the consciences of medical professionals.

HB 1247 expands protections for doctors, nurses, and other medical professionals who object to performing certain medical procedures on religious or moral grounds. The bill amends South Dakota's existing conscience protection law to strengthen safeguards that allow healthcare workers to refuse participation in procedures they find ethically objectionable without facing employment discrimination.

provide price transparency for health care costs.

HB 1263 creates new rules requiring health insurers to provide patients with clear, upfront information about what they'll have to pay out-of-pocket for specific health care services, including deductibles and other cost-sharing amounts. The bill establishes definitions and standards for how insurers must calculate and communicate these costs to help patients understand their financial responsibility before receiving care.

exempt health benefit plans sponsored by nonprofit agricultural organizations from insurance regulation.

# SB 87 Summary Nonprofit agricultural organizations would no longer have to follow South Dakota's insurance regulations when offering health benefit plans to their members. This exemption allows these organizations to sponsor health plans without the oversight and requirements that typically apply to insurance companies in the state.

revise certain provisions regarding the use of telehealth technologies.

SB 96 updates South Dakota's definition of telehealth to clarify what technologies qualify as telehealth services, including interactive video, audio with recorded data, and remote patient monitoring, while specifically excluding basic phone calls, emails, and text messages. The bill also expands the definition of "health care facility" to formally include laboratories and clarifies that telehealth doesn't include services delivered under separate pharmacy regulations or through simple electronic communication methods.

establish criteria for a regional nursing facility designation.

This bill creates a new process for nursing facilities to apply for a "regional nursing facility" designation from the Department of Human Services. To qualify, facilities must be in good standing with Medicaid, develop a detailed plan assessing aging and healthcare needs in their service area, offer home and community-based services, and either build a new facility or significantly remodel an existing one within a 30-mile radius of other healthcare facilities they're merging with.

prohibit certain insurers from using genetic information.

SB178 removes an existing law that permitted certain insurers to use genetic information when making coverage or rate decisions. By repealing §7-8-16, the bill prohibits insurance companies from considering a person's genetic test results or family medical history as a factor in underwriting or pricing insurance policies. This protects South Dakotans from potential discrimination based on genetic predisposition to disease.

revise certain provisions regarding access critical nursing facilities.

South Dakota will update how it identifies nursing facilities that serve areas with limited healthcare options, called "access critical" facilities, which receive special Medicaid funding. The bill changes the eligibility requirement from looking at projected future demand to instead measuring actual current occupancy—a facility now qualifies if it averages 55 or fewer occupied beds over the past five years, rather than being evaluated on predicted future needs. This shift makes the designation process based on real usage data rather than forecasts.

revise certain provisions regarding the practice of chiropractic.

HB 1006 creates new definitions for chiropractic practice, including "chiropractic assistant" (a trained helper who works under a chiropractor's supervision), "chiropractic radiography" (X-rays used for diagnosis), and "chiropractic specialist" (a chiropractor with advanced training). The bill also clarifies the existing rule that practicing chiropractic without a current license is illegal, making it a Class 1 misdemeanor.

maintain the life of any child born alive.

HB1051 requires physicians to use the same medical means and skills to preserve the life of any child born alive during an abortion procedure as they would for any other newborn, and mandates immediate hospital admission for such infants. The bill also establishes that a physician performing an abortion that results in a live birth has a legal responsibility to that child and creates new civil and disciplinary consequences for failure to comply with these requirements.

revise certain provisions regarding the abuse of health insurance.

This bill clarifies that direct payments patients make to health care providers for services—without involving insurance—can count toward their insurance deductibles and co-payments, and it prevents insurers from punishing providers who share cost and pricing information with patients. The change adds protections for patients seeking transparent pricing information before receiving care.

revise the authority of the Department of Health as it relates to counties and municipalities.

This bill clarifies that counties and municipalities cannot override or bypass the South Dakota Department of Health's authority over public health matters. The change removes language that gave municipalities broad power to act on health issues, replacing it with a more limited authority that must stay within the bounds of state health department rules.

require that assisted living facilities create and post visitation policies.

# HB 1139 Summary Assisted living facilities in South Dakota must develop written visitation policies and post them where residents and visitors can see them. This ensures transparency about visiting hours, procedures, and any restrictions facilities may have in place.

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 stabilize individual health insurance markets by sharing the cost of very expensive medical claims. The program will assess health insurers based on their premium earnings and use those funds to reimburse insurers for high-cost claims that exceed certain thresholds, which should help keep individual health insurance premiums more stable and affordable.

revise provisions related to physician assistants.

HB 1163 changes how physician assistants work in South Dakota by replacing the requirement for "supervision" by a doctor with a new "collaboration" model where physician assistants and physicians consult and share expertise instead. The bill also allows physician assistants to have collaborative agreements with other licensed physicians or even other physician assistants, rather than being limited to a single supervising doctor.

authorize the participation of certified registered nurse anesthetists in the recruitment assistance program.

Certified registered nurse anesthetists can now participate in South Dakota's recruitment assistance program, which helps attract healthcare professionals to underserved areas of the state. Previously, this program did not include nurse anesthetists among the eligible professions that could receive recruitment support.

impose a tax on the gross receipts of ambulatory surgery centers and surgical specialty hospitals, provide a penalty for a violation thereof, and to declare an emergency.

HB 1246 creates a new tax on the gross receipts (total revenue) of ambulatory surgery centers and surgical specialty hospitals in South Dakota. The bill modifies the state's tax code to establish this tax requirement and includes penalties for facilities that fail to pay it.

require reports regarding the intentional disposal, destruction, or other disposition of human embryos.

HB 1248 requires fertility clinics and other medical facilities to report to the state when they intentionally dispose of, destroy, or otherwise get rid of human embryos. The bill amends existing law to establish new reporting requirements and oversight for the handling of embryos in medical settings.

provide for the calculation of cost-sharing requirements regarding pharmacy benefits management.

This bill requires health plans and pharmacy benefits managers to count all amounts a patient pays toward their deductibles, copayments, and other out-of-pocket costs—including payments made by other people on their behalf—when calculating how much the patient has contributed toward their annual limits. The change ensures patients get credit for all their costs, not just what they personally pay out of pocket, which could help them reach their coverage limits faster.

revise certain provisions regarding the health professionals assistance program.

This bill revises South Dakota's health professionals assistance program to clarify that it serves health professionals whose mental health or substance abuse issues prevent them from practicing safely, and it updates the definition of "impaired" to specifically reference unmanaged mental health and substance use disorders. The changes also restructure how the program's key terms are numbered and defined in state law, making the language more consistent and precise about what conditions qualify professionals for assistance rather than disciplinary action.

authorize primary care agreements.

South Dakota's HB1131 creates a new legal framework allowing doctors and other primary care providers to offer "direct primary care" services—where patients pay the provider a monthly or periodic fee directly rather than using insurance billing. Under this arrangement, providers cannot bill insurance companies for individual visits, and patients' per-visit charges must stay below their monthly fee amount. The bill clarifies that these direct primary care agreements are not insurance products and won't be regulated under South Dakota's insurance laws.

provide for physician wellness programs.

South Dakota creates a new physician wellness program that doctors and physician assistants can voluntarily join to address career stress and burnout through counseling or other support services. Records of participation in these programs are kept confidential and protected from discovery in lawsuits or reporting to medical boards, unless the physician voluntarily releases the information or the disclosure involves reporting criminal conduct or professional misconduct. Tax-exempt medical associations in the state are authorized to establish and operate these wellness programs.

limit liability for certain exposures to COVID-19.

This bill creates a new legal protection that shields health care professionals, health care facilities, first responders, and others from being sued for COVID-19 exposures that occur while they are performing their duties in good faith. The law defines COVID-19 and related terms to establish which workers and facilities qualify for this liability protection.

prohibit employment contracts restricting competitive health care practices.

South Dakota law currently allows employers to require employees not to compete in the same profession for up to two years after leaving their job, but this bill creates a new exception that makes such restrictions void and unenforceable for health care providers. Health care providers can no longer be legally bound by employment contracts that prevent them from practicing in any geographic area, treating current patients, or consulting with patients affiliated with their former employer after their employment ends. This change allows health care providers more freedom to continue practicing and serving patients without being restricted by non-compete clauses in their employment agreements.

revise the provisions regarding the South Dakota state employee health plan.

SB57 revises the definitions and rules governing South Dakota's state employee health plan by amending the civil service laws that cover state workers. The bill updates the definitions section that applies to state employee health insurance and related benefits, though the specific substantive changes to coverage, costs, or eligibility would depend on the complete text beyond what is shown in this excerpt.

transfer funds to the health care trust fund and to declare an emergency.

HB 1273 transfers funds into South Dakota's health care trust fund and declares an emergency to allow the transfer to take effect immediately rather than on the usual delayed timeline. The bill modifies the rules governing how money flows into this trust fund to ensure healthcare resources are available without waiting for standard implementation procedures.

make an appropriation to improve healthcare in South Dakota and to declare an emergency.

HB1173 appropriates $1 from South Dakota's general fund for healthcare improvements across the state and declares the funding an emergency so it takes effect immediately upon the governor's approval. Any portion of this appropriation not spent or committed by June 30, 2025 will be returned to the general fund following standard reversion procedures.