Search Bills

establish provisions for the coverage of nonopioid prescription drugs.

Health insurers in South Dakota would be prohibited from denying coverage of nonopioid pain medications when a doctor prescribes them, and cannot place stricter prior approval requirements or higher patient costs on nonopioid drugs than they do on opioid drugs. This requirement applies to all health insurance policies delivered or renewed in the state and aims to encourage the use of safer pain management alternatives to opioids.

revise provisions related to birth centers and the practice of certified professional midwives at birth centers.

This bill updates South Dakota's rules for birth centers and the certified professional midwives who work in them, primarily by clarifying licensing requirements and reorganizing how those requirements are stated in state law. The bill repeals one outdated regulation and modifies several others to streamline the licensing process and patient safety protocols that birth centers must follow. The specific changes include adjusting application procedures, clarifying which facilities are exempt from these rules, and refining the risk assessment requirements that birth centers must implement.

establish provisions related to the disclosure of COVID-19 and mRNA vaccination status and blood donations.

Blood banks in South Dakota must ask donors whether they've received a COVID-19 or mRNA vaccine and label blood bags from vaccinated donors accordingly, without revealing the donor's identity. Patients needing non-emergency blood transfusions can request blood from either vaccinated or unvaccinated donors, and healthcare providers must honor that request if the requested blood is available and cannot refuse care based on a patient's preference.

address prior authorization and reporting requirements by utilization review organizations and health carriers.

HB 1199 requires health insurance companies and utilization review organizations to track and annually report data on their prior authorization decisions to South Dakota's Division of Insurance, including how many requests they approved or denied and how quickly they made decisions. The Division of Insurance must then publish these reports publicly online within 60 days so patients and the public can see how insurance companies handle prior authorization requests for medical care.

limit the ability of a health carrier to recoup, recover, or retroactively deny previously paid claims.

Health insurance companies can now only take back or deny payment for previously paid claims within 18 months of paying them, and only if they give the provider written notice of why—this protects providers from surprise claim denials years later. The rule has exceptions for claims involving fraud, waste, abuse, or claims involving other insurance types like Medicare, Medicaid, workers' compensation, or when a provider was already paid for the same service. The Division of Insurance will enforce this new requirement.

place requirements on the use of artificial intelligence systems by health carriers in making determinations about the provision of health care services.

Health insurance companies in South Dakota must now follow specific rules when using artificial intelligence or similar software tools to decide whether to approve payment for health care services. These tools must consider each patient's individual medical history and circumstances rather than relying solely on group data, and must be applied consistently and equally to all patients under a health plan. The requirement applies to both tools the insurance companies use directly and tools used by contractors they work with.

prohibit certain billing practices by ambulance service providers and establish reimbursement standards for out-of-network emergency medical services.

SB 211 prohibits ambulance service providers from billing patients directly for emergency medical services when the provider is out-of-network with the patient's insurance plan. The bill establishes that out-of-network ambulance providers must seek reimbursement from insurance plans rather than patients, protecting South Dakotans from unexpected medical bills for emergency transport services.

prohibit the assessment of certain administrative fees or penalties related to the provision of care by an out-of-network provider.

Health insurance companies in South Dakota are prohibited from charging doctors or other healthcare providers administrative fees or penalties when a patient receives care from a provider outside the insurance network. This protects in-network providers from being penalized by insurers for situations involving out-of-network care.

establish requirements and liability protection for registered nurses and licensed practical nurses serving on ambulance crews.

This bill allows registered nurses and licensed practical nurses to serve on ambulance crews alongside or instead of traditional emergency medical technicians, expanding who can provide emergency medical care during ambulance runs. The bill also creates liability protections for nurses working on ambulances and establishes that a physician assistant or nurse practitioner can supervise an ambulance service instead of requiring a physician medical director. These changes give ambulance services more flexibility in staffing while maintaining medical oversight of emergency care.

require that terminal care facilities allow terminally ill patients to use medical cannabis.

This bill requires terminal care facilities to allow terminally ill patients to use medical cannabis, even though existing law lets most health care facilities restrict its use. The bill creates an exception so that patients at end-of-life care facilities cannot be prevented from using medical cannabis that they are legally authorized to possess.

authorize the dispensing of ivermectin and hydroxychloroquine under a written protocol developed by a health care provider, and to provide liability protection therefor.

This bill allows pharmacists to dispense ivermectin and hydroxychloroquine to adults without a patient-specific prescription, as long as they follow a written protocol created by a licensed healthcare provider that includes risk screening and safety information. Pharmacists and other healthcare providers who follow the protocol in good faith are protected from criminal charges, lawsuits, and professional discipline—except in cases of gross negligence or intentional misconduct.

protect certain rights of healthcare providers.

HB 1153 creates new legal protections for healthcare providers, including doctors, nurses, pharmacists, and healthcare organizations, allowing them to decline participation in medical services based on their ethical, moral, or religious beliefs. The law applies broadly to individual healthcare workers as well as hospitals, clinics, insurers, and other entities that pay for or arrange medical services. This gives healthcare providers a legal right to refuse involvement in certain medical procedures without losing their license or facing state penalties.

prohibit certain persons from requiring genetic-based vaccinations.

This bill prohibits employers and government agencies from requiring employees to receive vaccines developed using genetic material technology (such as mRNA vaccines) as a condition of employment or treatment during public health emergencies. It also clarifies that individuals suspected of having serious communicable diseases cannot be forced to accept genetic-based vaccines as part of their treatment, though they may still be required to accept other diagnoses and treatments.

require the licensure of non-medical home care agencies, and to provide a penalty therefor.

South Dakota will now require companies that provide non-medical home care services—such as assistance with bathing, meal preparation, medication reminders, and companionship—to obtain a state license from the Department of Health before operating in the state. Anyone who operates or advertises a home care agency without this license will face criminal penalties as a Class 1 misdemeanor. This creates a new licensing requirement where previously no state oversight existed for these types of home care businesses.

establish a data collection system pertaining to assisted reproductive technology and to provide a penalty therefor.

South Dakota will require fertility clinics and other providers of assisted reproductive technology to report detailed data annually to the Department of Health, including information about embryos created, tested, implanted, and disposed of, as well as pregnancy and birth outcomes. This is a new requirement with no existing state law on the topic, meaning fertility providers must now track and submit this information to help the state monitor assisted reproductive technology practices.

safeguard the integrity, privacy, and security of genetic data and provide a civil penalty therefor.

South Dakota is creating new privacy protections for people who use direct-to-consumer genetic testing companies like ancestry or health DNA kits. The law requires these companies and their service providers to get clear written consent from consumers before collecting, using, or sharing their genetic information, and establishes civil penalties for violations.

clarify that consent for the donation of ovum or sperm must be explicit.

This bill clarifies that agreeing to be an organ donor does not automatically mean a person consents to donate eggs or sperm—separate, explicit consent is required for reproductive material. The law prevents eggs or sperm from being retrieved or used without a donor's specific, informed agreement to that particular donation.

amend the definition of an abortion.

This bill clarifies South Dakota's definition of abortion to specify that it means intentionally ending a pregnancy, while explicitly excluding accidental deaths during medical treatment, miscarriage care, ectopic pregnancy treatment, and procedures to save the unborn child's life or health. The change ensures that doctors providing standard medical care—like treating complications or infections—cannot be prosecuted under the state's abortion law as long as any fetal death is unintentional.

modify provisions related to the practice of pharmacy.

SB14 updates South Dakota's pharmacy regulations by revising definitions and rules governing how pharmacists can practice, including changes to what counts as drug "compounding" and how pharmacists can work with patients and other healthcare providers. The bill streamlines several regulatory sections, eliminates one outdated rule, and adds new provisions to clarify pharmacist responsibilities and scope of practice. These changes modernize the state's pharmacy laws to reflect current professional standards and practices.

establish the crime of fraudulent assisted reproduction and provide a penalty and civil liability therefor.

This bill creates a new crime called "fraudulent assisted reproduction" that makes it illegal for health care providers to use someone else's sperm or eggs in a fertility procedure without the patient's written consent, or to use their own reproductive material without consent—punishable as a Class 5 felony. The bill also allows patients and certain other individuals to sue health care providers who commit this crime for damages. Importantly, the time limit to prosecute these crimes doesn't start until the victim discovers and reports the fraud to law enforcement.

create the community-based providers methodology supplement fund, create the target teacher salary supplement fund, and provide for the transfer of certain unobligated cash balances to the fund.

This bill creates two new dedicated funds: one to increase teacher salaries and another to boost payment rates for community-based healthcare providers. Money for these funds will come from transferring unobligated cash balances from other state accounts, with the funds administered by the Department of Education and Department of Human Services respectively. The bill repeals an existing section and modifies budget-related laws to establish these new funding mechanisms.

reschedule the pharmaceutical composition of crystalline polymorph psilocybin in a drug product approved by the Food and Drug Administration as a Schedule IV controlled substance.

South Dakota is reclassifying psilocybin from a banned Schedule I drug to a less-restricted Schedule IV controlled substance, but only when it's in a specific crystalline form approved by the FDA as a pharmaceutical product. This change allows FDA-approved psilocybin medications to be legally used in the state while keeping naturally occurring psilocybin illegal.

prohibit an insurer from declining or limiting life, disability, or long-term care insurance policies based solely on an individual's status as a living organ donor.

Insurance companies in South Dakota cannot refuse to sell or reduce benefits on life, disability, or long-term care insurance policies simply because someone is a living organ donor. The law also prevents insurers from charging higher prices, canceling policies, or otherwise discriminating against organ donors in any way, unless the insurer can show actual additional health risk beyond just the donation itself.

make an appropriation to increase the rate of payment for federally qualified health centers.

This bill provides $8 million in funding ($4 million state money and $4 million in federal matching funds) to increase what the state pays federally qualified health centers for medical services they provide. The higher payment rates will take effect on June 30, 2026, and any unused money will be returned to the state fund.

revise the types of community-based providers for purposes of state funded services.

This bill expands the types of health care and social service providers eligible to receive state funding (including Medicaid and federal grants) by adding critical access hospitals and Federally Qualified Health Centers to the list of covered community-based providers. The bill also gives the secretaries of the Department of Social Services and Department of Human Services flexibility to add other provider types they deem appropriate without needing legislative approval.

permit a school district to administer epinephrine using a nasal spray.

South Dakota schools can now stock and use epinephrine nasal spray in addition to the auto-injector devices they already use to treat severe allergic reactions during school hours. School nurses and designated staff members can administer either form of epinephrine to any student showing signs of anaphylaxis, even without a prior prescription on file, provided they've received proper training from a licensed health care professional.

revise the scope of practice for occupational therapy.

HB1223 expands what occupational therapists in South Dakota are allowed to do by adding new techniques like "instrument-assisted modalities"—treatments using special tools or instruments to treat muscles, fascia, and tissue—to their scope of practice. The bill also updates the legal definitions and requirements for occupational therapists and their practice to reflect these expanded capabilities.

clarify and establish requirements related to forensic medical examinations.

SB87 clarifies that counties must pay for the complete costs of forensic medical examinations for rape and sexual assault victims, including hospital services, lab tests, medications, and imaging—and specifies that victims don't have to report the crime or cooperate with police to receive this free examination. The bill also requires hospitals and clinics to work with counties to set up payment processes and inform victims that these exams are available at no cost to them.

provide requirements related to the cardiac health evaluation of minors.

South Dakota schools must now require students to get a cardiac health screening within one year before participating in school-sponsored athletics, with a licensed health care provider documenting the exam on a state-approved form that includes questions about the student's personal and family cardiac history. The Department of Health will create educational materials about sudden cardiac arrest and screening options, which schools must distribute to all students at the start of each academic year. Students cannot participate in school athletics without providing their signed physical exam form to their school.

require that the Department of Social Services submit a federal waiver request to exclude soft drinks from the supplemental nutrition assistance program.

South Dakota's Department of Social Services must request federal permission to ban soft drinks (beverages with added sweeteners, excluding milk and approved juices) from the state's SNAP food assistance program by September 1, 2026. If approved, the department will implement the restriction within six months; if denied, it must resubmit the request every year until it succeeds. This creates a new state requirement to pursue what is currently not allowed under federal SNAP rules.

require that the Department of Health accept the medical records of a veteran applying for a medical cannabis registry identification card.

Veterans applying for a medical cannabis registry card can now use their existing medical records instead of requiring a new written certification from a doctor within 90 days of applying. The Department of Health must accept these veteran medical records as valid documentation, streamlining the application process for this group.

permit the use of biological filtration systems in water recreational facilities located in certain lodging establishments.

Small lodging establishments with 15 or fewer rooms can now use biological filtration systems (instead of traditional chemical filtration) in their pools or hot tubs, but only with a state permit that requires annual inspections and proof that the system meets water quality standards. The state health department will set the specific rules for permits, maintenance requirements, testing procedures, and a permit fee capped at $50 per year.

limit the potency of cannabis products sold at medical cannabis dispensaries.

South Dakota medical cannabis dispensaries would be prohibited from selling cannabis products that exceed specified potency limits: flower at 30% THC, liquid concentrates at 60% THC, edibles at 5mg THC per serving (100mg per container), and cannabis oil at 5% THC. This new rule caps the strength of medical cannabis products currently available to patients at state-licensed dispensaries.

authorize the possession and self-administration of diabetes medications by a student on school property and at school-related events and activities.

This bill allows students diagnosed with diabetes to carry and use their insulin and diabetes medications on school property and at school events without needing special permission from school officials, as long as their parents provide written authorization and release the school from liability. The change expands existing rules that previously only allowed students to self-administer asthma inhalers and epinephrine auto-injectors to now include diabetes medications and related supplies.

require the reimbursement of therapy using equine movement through the state medicaid program.

South Dakota's Medicaid program would now cover equine therapy (therapeutic activities using horses) when provided by licensed physical therapists, occupational therapists, or speech-language pathologists. The state Department of Social Services must submit paperwork to the federal government by August 2026 to formally add this coverage to the Medicaid program.