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establish licensure for rural emergency hospitals.

South Dakota is creating a new type of licensed healthcare facility called a "rural emergency hospital" by adding it to the state's definition of what counts as a health care facility. This allows rural areas to operate emergency-only hospitals with a different licensing structure than traditional full-service hospitals, potentially making emergency care more accessible in underserved communities.

prohibit forms of discrimination in access to organ transplantation.

South Dakota would prohibit hospitals, health care providers, and organ matching organizations from discriminating against people with disabilities when deciding who receives organ transplants. The law requires these entities to provide auxiliary aids—such as interpreters, accessible materials, and decision-making support—to ensure people with disabilities have equal access to transplant evaluation and treatment. This creates new protections so that disability alone cannot be a reason to deny someone consideration for a life-saving transplant.

allow medical practice on the basis of conscience.

This bill creates a new legal right allowing doctors and other medical practitioners to make treatment decisions based on their personal conscience, even if those decisions conflict with state or federal laws, regulations, or rules. The bill essentially gives medical practitioners the authority to determine patient care based on what they believe is best, rather than requiring them to follow established medical standards or legal requirements. This is a significant change because it prioritizes a provider's personal beliefs over existing law and regulatory guidelines.

repeal a physician's ability to prescribe the number of cannabis plants a cardholder may cultivate.

This bill removes physicians' ability to prescribe higher numbers of cannabis plants for medical cardholders in South Dakota. Currently, doctors can recommend that patients grow more than the three-plant minimum, but this change would lock all cultivation cardholders at exactly three plants regardless of their medical needs.

revise certain provisions related to advanced life support personnel.

HB 1121 updates South Dakota's definitions of advanced life support personnel to clarify which types of emergency medical technicians qualify for this designation, specifically listing EMT-Intermediate/85, EMT-Intermediate/99, EMT-Advanced, and EMT-Paramedic as the approved levels. The bill also expands the scope of what "emergency medical technician-advanced" means by explicitly authorizing them to perform additional procedures like placing esophageal and supraglottic airways and starting intravenous lines, which were not previously listed in state law.

revise the definition of telehealth for purposes of health insurance policies.

South Dakota is expanding its definition of telehealth to include a broader range of digital communication methods beyond just video calls—now including secure electronic messaging, imaging, and other communication technologies that comply with privacy rules. Previously, telehealth was narrowly defined as only interactive audio-video conversations, which excluded phone calls, emails, and text messages. This change allows health insurance policies to cover more types of remote healthcare delivery.

permit certain facilities to establish reasonable restrictions related to the medical use of cannabis.

Hospitals and substance abuse treatment facilities can now set their own rules restricting patients' use of medical cannabis on their premises, even if patients have a valid medical cannabis card. The bill clarifies that these healthcare facilities have the authority to prohibit or limit cannabis use in ways that go beyond state law's general protections for registered medical cannabis cardholders.

revise the definition of bona fide practitioner-patient relationship.

This bill changes the definition of what counts as a valid doctor-patient relationship for medical marijuana cardholders in South Dakota. Specifically, it requires doctors to complete a medical assessment and perform an in-person physical examination **at every visit** (rather than just initially), and to consult with patients about their specific medical condition and offer follow-up care. This stricter definition makes it harder for patients to qualify for medical marijuana cards by requiring more rigorous and ongoing doctor oversight.

provide for an inalienable right to bodily integrity.

This bill creates a new legal right guaranteeing that South Dakotans cannot be forced to accept medical treatments and cannot face discrimination or lose benefits for refusing medical interventions. It also prohibits giving preferential treatment to people who accept medical procedures. The law essentially protects medical choice by preventing employers, insurers, schools, and other entities from penalizing individuals who decline vaccines, medications, or other medical interventions.

permit designated visitors in nursing facilities.

Nursing facility residents gain the right to designate two specific visitors who can stay up to 12 hours per day (or unlimited hours if receiving end-of-life care) to help with daily activities, emotional support, or companionship—and these visitors cannot be denied entry to the facility. Facilities can still restrict where designated visitors go within the building and can require them to follow the same health and safety precautions (like personal protective equipment) that staff members must follow, with the facility covering equipment costs.

protect an individual's conscience from entities requiring the COVID-19 vaccine.

This bill makes COVID-19 vaccination records strictly confidential and prohibits anyone from sharing or requesting an individual's vaccination status without their written consent, with limited exceptions for disease control investigations and protecting named individuals' health. Violations—such as a doctor's office or employer disclosing someone's vaccine status without permission—would be punishable as a Class 1 misdemeanor. The bill also allows the Department of Health to use vaccination data only for anonymous statistics or disease prevention purposes.

allow certain medical professionals to dispense ivermectin to persons.

HB 1267 allows certain medical professionals—beyond just physicians—to dispense ivermectin directly to patients without requiring a prescription from a doctor. The bill expands who can distribute this medication by amending the state's pharmacy and medical practice laws to permit qualified healthcare providers to provide ivermectin to people seeking it.

revise provisions related to physician assistants.

SB134 revises South Dakota's rules for physician assistants by allowing two new types of supervisors: experienced physician assistants (with at least 4,000 practice hours) can now supervise newer physician assistants, not just licensed doctors. The bill also clarifies that practice collaborative agreements—the written contracts between physician assistants and their supervisors—must be kept on file at the physician assistant's main workplace and must outline the terms of their working relationship.

revise the definition of practitioner for purposes of the medical cannabis program.

This bill revises who can serve as a "practitioner" in South Dakota's medical cannabis program by updating the definition in state law. The bill specifies the requirements for a valid practitioner-patient relationship, including that practitioners must complete a medical assessment and in-person physical exam of patients and remain available for follow-up care. This change clarifies and potentially expands which healthcare providers can authorize medical cannabis use in the state.

Celebrating the Madison High School football team for winning the Class 11A state championship.

This bill celebrates the Madison High School football team's Class 11A state championship. The bill appears to be a ceremonial resolution with no substantive changes to South Dakota law.

provide a reimbursement schedule for chiropractic, dental, and optometric services under the Medicaid program.

This bill requires South Dakota's Department of Social Services to create and publish an official reimbursement schedule that sets payment rates for dental services provided to Medicaid patients. The department must base these payment rates on what dentists typically charge for services in South Dakota and can get help from outside experts to determine those standard fees. The reimbursement schedule will be established through state administrative rules and adjusted annually.

provide for the redistribution of donated prescription drugs and medical supplies.

This bill creates a new program allowing licensed pharmacies in South Dakota to accept donations of unused prescription drugs and medical supplies, provided the items are in original sealed packaging and won't expire for at least six months. Donated drugs and supplies must be inspected by a licensed pharmacist before being dispensed to patients, and pharmacies must register with the State Board of Pharmacy to participate in the program. The bill prohibits donations of controlled substances and any medications showing signs of tampering or deterioration.

expand the ability for patients to seek investigational drugs, biological products, or devices.

HB 1228 expands access to experimental drugs, biological products, and devices for patients with advanced or serious illnesses by allowing them to try investigational treatments that have completed early safety testing but haven't yet received FDA approval. The bill defines "eligible patients" as those with progressive conditions like advanced illness or serious illness (involving extreme pain or permanent disability) who have exhausted standard treatment options. This creates a pathway for terminally ill or severely ill South Dakotans to seek access to experimental treatments outside of traditional clinical trials.

provide for an examination via telehealth for purposes of a bona fide practitioner-patient relationship under the medical cannabis program.

HB 1280 allows doctors to conduct initial medical cannabis patient examinations using telehealth (video conferencing) instead of requiring an in-person visit to establish a valid doctor-patient relationship. This change makes it easier for South Dakota patients to get medical cannabis certifications without traveling to see a healthcare provider in person.

address transparency in prescription drug pricing.

SB 163 updates South Dakota's prescription drug pricing transparency law by clarifying which organizations must follow the transparency rules—including nonprofits, health insurers, employers, and labor unions that provide health coverage to state residents. The bill also refines definitions of key terms like "generic drug" and "labeler" to ensure the law applies consistently across the state's health coverage system.

revise provisions regarding medical cannabis.

SB 177 updates South Dakota's medical cannabis law to clarify what patients can legally possess and use. The bill defines "allowable amounts" of cannabis to include up to three ounces of the plant itself, plus cannabis products made from home-grown plants, and establishes that doctors must conduct in-person examinations and follow-up care to approve patients for medical cannabis use. These changes provide clearer rules for both patients and healthcare providers participating in the state's medical cannabis program.

establish provisions for medical services.

revise provisions related to a written certification for the medical use of cannabis.

This bill clarifies the rules for South Dakota's medical cannabis program by defining what counts as an "allowable amount" of cannabis that patients can possess—including up to three ounces, cannabis products established by state rules, and for those approved to grow, three or more plants as their doctor prescribes. It also refines what makes a valid doctor-patient relationship for medical cannabis use, requiring doctors to conduct an in-person physical exam, discuss the patient's condition, and offer ongoing care.

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

HB1226 appropriates $1 from the state general fund to improve healthcare across South Dakota and declares an emergency so the law takes effect immediately. Any money not spent or committed by June 30, 2026 will be returned to the general fund according to standard procedures.