South Dakota insurance laws

What it would do: Prohibits insurers from declaring a motor vehicle a total loss due to collision, fire, vandalism, weather, or other peril unless repair costs meet or exceed 75 percent of the vehicle's actual cash value, unless the owner requests and authorizes total loss declaration in writing.

What it would do: Prohibits ambulance service providers from billing patients for out-of-network emergency medical services except for coinsurance, copayments, or deductibles. Requires health benefit plans to reimburse out-of-network providers at rates established by the political subdivision or 275% of Medicare allowable rates, whichever is less.

What it would do: Prohibits health carriers from assessing or imposing administrative fees or penalties on health care providers for any provision of care involving an out-of-network provider.

What it would do: Requires health carriers using artificial intelligence for utilization review to base determinations on individual patient clinical information, apply tools equally across patients, and prohibits AI from denying or delaying care without licensed physician review. Mandates annual reporting and Division of Insurance compliance inspections.

What it would do: Prohibits health insurers from denying coverage of nonopioid prescription drugs prescribed by physicians in favor of opioids, and requires that prior authorization and step therapy requirements for nonopioid drugs be no more restrictive than those for opioids, and that nonopioid drugs not be placed on higher cost-sharing tiers than opioids.

What it would do: Requires public improvement contracts between contractors and purchasing agencies to include provisions authorizing the purchasing agency to verify workers' compensation insurance before work begins and monitor coverage during the contract by requesting documentation of premium payments, subcontractor lists, payroll records, and other information to prevent workers' compensation fraud.

What it would do: Increases motor vehicle liability insurance requirements from 25/50/25 thousand dollars to 50/100/50 thousand dollars for bodily injury per person, per accident, and property damage per accident.

What it would do: Requires contracts for public improvements to include provisions verifying that contractors and subcontractors have obtained workers' compensation insurance. Grants the Department of Labor and Regulation and purchasing agencies authority to investigate and monitor insurance coverage and requires contractors to provide subcontractor lists, payroll records, and other compliance information.

What it would do: Requires the Department of Social Services and health insurers to ensure non-opioid pain drugs approved by the FDA are not disadvantaged relative to opioids on preferred drug lists and formularies, and prohibits insurers from denying coverage of prescribed non-opioid pain drugs in favor of opioids.

What it would do: Requires settlement agreements by the Associated School Boards of South Dakota Protective Trust Workers Compensation Pool to comply with disclosure requirements in § 1-27-1.23, include a provision stating terms and amounts are discoverable unless exempt, and voids any conflicting provisions in agreements entered after July 1, 2025.

What it would do: Requires health maintenance organizations and insurers to provide practitioners an opportunity to discuss treatment plans before issuing adverse determinations, and establishes preauthorization exemptions for practitioners with 90% approval rates over twelve months, with specific rescission and appeal procedures.

What it would do: Requires insurers and third-party administrators to submit medical, dental, and pharmaceutical claims data to the Division of Insurance to establish and maintain a health care data system for planning, research, quality assessment, and public transparency, with civil penalties up to one thousand dollars per occurrence for non-compliance.

What it would do: Requires health insurance policies, group health policies, and small employer health benefit plans delivered or renewed in South Dakota on or after January 1, 2026, to cover biomarker testing ordered by qualified health care providers when supported by medical and scientific evidence for diagnosis, treatment, management, or monitoring of disease or condition.

What it would do: Prohibits health insurance policies and group health insurance policies from imposing cost-sharing requirements on screening, diagnostic, or supplemental breast imaging examinations when medically necessary, with an exception for health savings account-qualified high deductible health plans regarding deductibles above the minimum required.