<html xmlns="http://www.w3.org/1999/xhtml" lang="en-US"><head><meta charset="UTF-8"><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17K - HEALTH CARE COST TRANSPARENCY</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s2083838Normal { text-align: center; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083838HG4 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2083838DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083838Normal-000000 { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083838000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083838B { margin-left: 1.38in; text-indent: -1.38in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } </style><meta name="viewport" content="width=device-width, initial-scale=1"><meta name="twitter:card" content="summary"><meta property="og:title" content="SD 58-17K - HEALTH CARE COST TRANSPARENCY"><meta property="og:description" content="SDLRC Codified Law 58-17K - HEALTH CARE COST TRANSPARENCY"><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-17K"><meta property="og:image" content="https://lawmakerdocuments.blob.core.usgovcloudapi.net/photos/logoshape.webp"><meta property="og:site_name" content="South Dakota Legislature"></head><body><div><p dir="ltr" class="s2083838Normal"><span xml:space="preserve" class="s2083838HG4">CHAPTER </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K" rel="noopener"><span class="s2083838DefaultParagraphFont">58-17K</span></a></p><p dir="ltr" class="s2083838Normal"><span class="s2083838DefaultParagraphFont">HEALTH CARE COST TRANSPARENCY</span></p><p dir="ltr" class="s2083838Normal-000000"><span xml:space="preserve" class="s2083838000001"> </span></p><p dir="ltr" class="s2083838B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-1" rel="noopener"><span class="s2083838DefaultParagraphFont">58-17K-1</span></a><span xml:space="preserve" class="s2083838DefaultParagraphFont">    Definitions.</span></p><p dir="ltr" class="s2083838B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-2" rel="noopener"><span class="s2083838DefaultParagraphFont">58-17K-2</span></a><span xml:space="preserve" class="s2083838DefaultParagraphFont">    Cost-sharing information described--Required disclosure to enrollees.</span></p><p dir="ltr" class="s2083838B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-3" rel="noopener"><span class="s2083838DefaultParagraphFont">58-17K-3</span></a><span xml:space="preserve" class="s2083838DefaultParagraphFont">    Cost-sharing information disclosed--Required internet method and format.</span></p><p dir="ltr" class="s2083838B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-4" rel="noopener"><span class="s2083838DefaultParagraphFont">58-17K-4</span></a><span xml:space="preserve" class="s2083838DefaultParagraphFont">    Cost-sharing information disclosed--Paper or other method on request--Limit on providers per request.</span></p><p dir="ltr" class="s2083838B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-5" rel="noopener"><span class="s2083838DefaultParagraphFont">58-17K-5</span></a><span xml:space="preserve" class="s2083838DefaultParagraphFont">    Prescription drug file--Required public disclosure--Method, format, and updates.</span></p><p dir="ltr" class="s2083838B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-6" rel="noopener"><span class="s2083838DefaultParagraphFont">58-17K-6</span></a><span xml:space="preserve" class="s2083838DefaultParagraphFont">    Cost-sharing information or prescription drug file--Third party contract to provide information--Health insurer responsible.</span></p><p dir="ltr" class="s2083838B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-7" rel="noopener"><span class="s2083838DefaultParagraphFont">58-17K-7</span></a><span xml:space="preserve" class="s2083838DefaultParagraphFont">    Acting in good faith--Error or omission--Reliance on other entity.</span></p><p dir="ltr" class="s2083838B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-8" rel="noopener"><span class="s2083838DefaultParagraphFont">58-17K-8</span></a><span xml:space="preserve" class="s2083838DefaultParagraphFont">    Compliance with applicable laws required.</span></p><p dir="ltr" class="s2083838B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-9" rel="noopener"><span class="s2083838DefaultParagraphFont">58-17K-9</span></a><span xml:space="preserve" class="s2083838DefaultParagraphFont">    Applicability to certain plans.</span></p><p dir="ltr" class="s2083838B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-10" rel="noopener"><span class="s2083838DefaultParagraphFont">58-17K-10</span></a><span xml:space="preserve" class="s2083838DefaultParagraphFont">    Rules and regulations.</span></p><p dir="ltr" class="s2083838B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-11" rel="noopener"><span class="s2083838DefaultParagraphFont">58-17K-11</span></a><span xml:space="preserve" class="s2083838DefaultParagraphFont">    Plan years effective.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml" lang="en-US"><head><meta charset="UTF-8"><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17K - HEALTH CARE COST TRANSPARENCY</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s2083281Normal { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083281SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083281CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2083281Statute { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083281DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083281StatuteNumber1 { margin-left: 0.75in; text-indent: -0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083281000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083281NoIndent { text-indent: 0.00in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083281DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083281SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style><meta name="viewport" content="width=device-width, initial-scale=1"><meta name="twitter:card" content="summary"><meta property="og:title" content="SD 58-17K-1 - Definitions."><meta property="og:description" content="SDLRC Codified Law 58-17K-1 - Definitions."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-17K-1"><meta property="og:image" content="https://lawmakerdocuments.blob.core.usgovcloudapi.net/photos/logoshape.webp"><meta property="og:site_name" content="South Dakota Legislature"></head><body><div><p dir="ltr" class="s2083281Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-1" rel="noopener"><span class="s2083281SENU">58-17K-1</span></a><span xml:space="preserve" class="s2083281SENU">. </span><span xml:space="preserve" class="s2083281CL">Definitions. </span></p><p dir="ltr" class="s2083281Statute"><span class="s2083281DefaultParagraphFont">Terms used in this chapter mean:</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(1)    "Accumulated amount," the amount of financial responsibility an enrollee has incurred at the time a request for cost-sharing information is made, with respect to a deductible or out-of-pocket limit as calculated under rules promulgated by the director;</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(2)    "Billed charge," the total charges for an item or service billed to a health insurer by a provider;</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(3)    "Billing code," the code used by a health insurer or provider to identify a health care item or service for purposes of billing, adjudicating, and paying a claim for a covered item or service, including current procedural terminology (CPT) code, health care common procedure coding system (HCPCS) code, diagnosis-related group (DRG) code, national drug code (NDC), or other common payer identifier;</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(4)    "Bundled payment arrangement," a payment model under which a provider is paid a single payment for all covered items and services provided to an enrollee for a specific treatment or procedure;</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(5)    "Cost-sharing liability," the amount an enrollee is responsible for paying for a covered item or service under the terms of the health insurance coverage;</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(6)    "Cost-sharing information," information related to any expenditure required by or on behalf of an enrollee with respect to health care benefits that are relevant to a determination of the enrollee's cost-sharing liability for a particular covered item or service;</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(7)    "Covered item or service," an item or service, including a prescription drug, the cost for which is payable, in whole or in part, under the terms of the health insurance coverage;</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(8)    "Derived amount," the price that a health insurer assigns to an item or service for the purpose of internal accounting, reconciliation with providers, or submitting data;</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(9)    "Enrollee," an individual receiving health insurance coverage from a health insurer;</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(10)    "Historical net price," the retrospective average amount a health insurer paid for a prescription drug, inclusive of any reasonably allocated rebates, discounts, chargebacks, fees, and any additional price concessions received by the health insurer with respect to the prescription drug as calculated under rules promulgated by the director;</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(11)    "In-network provider," any provider of any item or service with which a health insurer or a third party for the insurer has a contract setting forth the terms and conditions on which a relevant item or service is provided to an enrollee;</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(12)    "Item or service," any encounters, procedures, medical tests, supplies, prescription drugs, durable medical equipment, and fees, including facility fees, provided or assessed in connection with the provision of health care;</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(13)    "Machine-readable file," a digital representation of data or information in a file that can be imported or read by a computer system for further processing without human intervention, while ensuring no semantic meaning is lost;</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(14)    "Negotiated rate," the amount a health insurer has contractually agreed to pay an in-network provider, including an in-network pharmacy or other prescription drug dispenser, for covered items and services, whether directly or indirectly, including through a third-party administrator or pharmacy benefit manager;</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(15)    "Out-of-network allowed amount," the maximum amount a health insurer will pay for a covered item or service furnished by an out-of-network provider;</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(16)    "Out-of-network provider," a provider of any item or service that does not have a contract under an enrollee's health insurance coverage to provide items or services;</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(17)    "Out-of-pocket limit," the maximum amount that an enrollee is required to pay during a coverage period for the enrollee's share of the costs of covered items and services under the enrollee's health insurance coverage, including for self-only and other than self-only coverage, as applicable;</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(18)    "Prerequisite," concurrent review, prior authorization, and step-therapy or fail-first protocols related to a covered item or service that must be satisfied before a health insurer will cover the item or service. The term does not include a medical necessity determination generally or other forms of medical management techniques; and</span></p><p dir="ltr" class="s2083281StatuteNumber1"><span class="s2083281DefaultParagraphFont">(19)    "Underlying fee schedule rate," the rate for a covered item or service from a particular in-network provider, or a provider that a health insurer uses to determine an enrollee's cost-sharing liability for the item or service, if that rate is different from the negotiated rate or derived amount.</span></p><p dir="ltr" class="s2083281Normal"><span xml:space="preserve" class="s2083281000000"> </span></p><p dir="ltr" class="s2083281NoIndent"><span xml:space="preserve" class="s2083281DefaultParagraphFont-000001">Source: </span><span class="s2083281SCL">SL 2021, ch 213, § 1.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml" lang="en-US"><head><meta charset="UTF-8"><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17K - HEALTH CARE COST TRANSPARENCY</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s2083282Normal { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083282SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083282CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2083282Statute { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083282DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083282StatuteNumber1 { margin-left: 0.75in; text-indent: -0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } p.s2083282StatuteNumber2 { margin-left: 1.25in; text-indent: -0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083282000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083282NoIndent { text-indent: 0.00in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083282DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083282SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style><meta name="viewport" content="width=device-width, initial-scale=1"><meta name="twitter:card" content="summary"><meta property="og:title" content="SD 58-17K-2 - Cost-sharing information described--Required disclosure to enrollees."><meta property="og:description" content="SDLRC Codified Law 58-17K-2 - Cost-sharing information described--Required disclosure to enrollees."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-17K-2"><meta property="og:image" content="https://lawmakerdocuments.blob.core.usgovcloudapi.net/photos/logoshape.webp"><meta property="og:site_name" content="South Dakota Legislature"></head><body><div><p dir="ltr" class="s2083282Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-2" rel="noopener"><span class="s2083282SENU">58-17K-2</span></a><span xml:space="preserve" class="s2083282SENU">. </span><span xml:space="preserve" class="s2083282CL">Cost-sharing information described--Required disclosure to enrollees. </span></p><p dir="ltr" class="s2083282Statute"><span class="s2083282DefaultParagraphFont">At the request of an enrollee, the health insurer shall provide:</span></p><p dir="ltr" class="s2083282StatuteNumber1"><span class="s2083282DefaultParagraphFont">(1)    An estimate, which is accurate at the time of the request, of the enrollee's cost-sharing liability for a requested covered item or service furnished by a provider reflecting any cost-sharing reductions the enrollee would receive that is calculated based on:</span></p><p dir="ltr" class="s2083282StatuteNumber2"><span class="s2083282DefaultParagraphFont">(a)    Accumulated amounts;</span></p><p dir="ltr" class="s2083282StatuteNumber2"><span class="s2083282DefaultParagraphFont">(b)    In-network negotiated rate, reflected as a dollar amount, or underlying fee schedule rate, reflected as a dollar amount, to the extent it is different from the negotiated rate; and</span></p><p dir="ltr" class="s2083282StatuteNumber2"><span class="s2083282DefaultParagraphFont">(c)    Out-of-network allowed amount or any other rate that provides a more accurate estimate of an amount the health insurer will pay for the requested covered item or service, reflected as a dollar amount. In circumstances in which a health insurer reimburses an out-of-network provider a percentage of the billed charge for a covered item or service, the out-of-network allowed amount will be that percentage;</span></p><p dir="ltr" class="s2083282StatuteNumber1"><span class="s2083282DefaultParagraphFont">(2)    Information for an item or service subject to a bundled payment arrangement and a list of the items and services included in the bundled payment arrangement for which cost-sharing information is being disclosed;</span></p><p dir="ltr" class="s2083282StatuteNumber1"><span class="s2083282DefaultParagraphFont">(3)    If applicable, notification that coverage of a specific item or service is subject to a prerequisite; and</span></p><p dir="ltr" class="s2083282StatuteNumber1"><span xml:space="preserve" class="s2083282DefaultParagraphFont">(4)    Further information and consumer notices required for compliance with federal standards as provided under rules promulgated pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-26" rel="noopener"><span class="s2083282DefaultParagraphFont">1-26</span></a><span xml:space="preserve" class="s2083282DefaultParagraphFont"> by the director.</span></p><p dir="ltr" class="s2083282Normal"><span xml:space="preserve" class="s2083282000000"> </span></p><p dir="ltr" class="s2083282NoIndent"><span xml:space="preserve" class="s2083282DefaultParagraphFont-000001">Source: </span><span class="s2083282SCL">SL 2021, ch 213, § 2.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml" lang="en-US"><head><meta charset="UTF-8"><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17K - HEALTH CARE COST TRANSPARENCY</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s2083283Normal { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083283SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083283CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2083283Statute { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083283DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083283StatuteNumber1 { margin-left: 0.75in; text-indent: -0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } p.s2083283StatuteNumber2 { margin-left: 1.25in; text-indent: -0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083283000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083283NoIndent { text-indent: 0.00in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083283DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083283SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style><meta name="viewport" content="width=device-width, initial-scale=1"><meta name="twitter:card" content="summary"><meta property="og:title" content="SD 58-17K-3 - Cost-sharing information disclosed--Required internet method and format."><meta property="og:description" content="SDLRC Codified Law 58-17K-3 - Cost-sharing information disclosed--Required internet method and format."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-17K-3"><meta property="og:image" content="https://lawmakerdocuments.blob.core.usgovcloudapi.net/photos/logoshape.webp"><meta property="og:site_name" content="South Dakota Legislature"></head><body><div><p dir="ltr" class="s2083283Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-3" rel="noopener"><span class="s2083283SENU">58-17K-3</span></a><span xml:space="preserve" class="s2083283SENU">. </span><span xml:space="preserve" class="s2083283CL">Cost-sharing information disclosed--Required internet method and format. </span></p><p dir="ltr" class="s2083283Statute"><span class="s2083283DefaultParagraphFont">The cost-sharing information to be provided under this chapter shall be made available without a subscription or other fee through a self-service tool on a website that provides real-time responses based on cost-sharing information that is accurate at the time of request. A health insurer shall ensure the self-service tool allows enrollees to:</span></p><p dir="ltr" class="s2083283StatuteNumber1"><span class="s2083283DefaultParagraphFont">(1)    Search for cost-sharing information for a covered item or service by an in-network provider by inputting:</span></p><p dir="ltr" class="s2083283StatuteNumber2"><span class="s2083283DefaultParagraphFont">(a)    A billing code or a descriptive term;</span></p><p dir="ltr" class="s2083283StatuteNumber2"><span class="s2083283DefaultParagraphFont">(b)    The name of an in-network provider; and</span></p><p dir="ltr" class="s2083283StatuteNumber2"><span class="s2083283DefaultParagraphFont">(c)    Other factors utilized by the health insurer that are relevant for determining the applicable cost-sharing information;</span></p><p dir="ltr" class="s2083283StatuteNumber1"><span class="s2083283DefaultParagraphFont">(2)    Search for an out-of-network allowed amount, percentage of billed charges, or other rate for a covered item or service by an out-of-network provider by inputting:</span></p><p dir="ltr" class="s2083283StatuteNumber2"><span class="s2083283DefaultParagraphFont">(a)    A billing code or a descriptive term; and</span></p><p dir="ltr" class="s2083283StatuteNumber2"><span class="s2083283DefaultParagraphFont">(b)    Other factors utilized by the health insurer that are relevant for determining the applicable out-of-network allowed amount or other rate; and</span></p><p dir="ltr" class="s2083283StatuteNumber1"><span class="s2083283DefaultParagraphFont">(3)    Refine and reorder search results based on geographic proximity of in-network providers and the amount of the enrollee's estimated cost-sharing liability.</span></p><p dir="ltr" class="s2083283Normal"><span xml:space="preserve" class="s2083283000000"> </span></p><p dir="ltr" class="s2083283NoIndent"><span xml:space="preserve" class="s2083283DefaultParagraphFont-000001">Source: </span><span class="s2083283SCL">SL 2021, ch 213, § 3.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml" lang="en-US"><head><meta charset="UTF-8"><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17K - HEALTH CARE COST TRANSPARENCY</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s2083284Normal { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083284SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083284CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2083284Statute { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083284DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2083284000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083284NoIndent { text-indent: 0.00in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083284DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083284SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style><meta name="viewport" content="width=device-width, initial-scale=1"><meta name="twitter:card" content="summary"><meta property="og:title" content="SD 58-17K-4 - Cost-sharing information disclosed--Paper or other method on request--Limit on providers per request."><meta property="og:description" content="SDLRC Codified Law 58-17K-4 - Cost-sharing information disclosed--Paper or other method on request--Limit on providers per request."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-17K-4"><meta property="og:image" content="https://lawmakerdocuments.blob.core.usgovcloudapi.net/photos/logoshape.webp"><meta property="og:site_name" content="South Dakota Legislature"></head><body><div><p dir="ltr" class="s2083284Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-4" rel="noopener"><span class="s2083284SENU">58-17K-4</span></a><span xml:space="preserve" class="s2083284SENU">. </span><span xml:space="preserve" class="s2083284CL">Cost-sharing information disclosed--Paper or other method on request--Limit on providers per request. </span></p><p dir="ltr" class="s2083284Statute"><span xml:space="preserve" class="s2083284DefaultParagraphFont">An enrollee may request, in accordance with § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-3" rel="noopener"><span class="s2083284DefaultParagraphFont">58-17K-3</span></a><span class="s2083284DefaultParagraphFont">, the required cost-sharing information be provided in a paper form. In responding to such a request, a health insurer may limit the number of providers to no fewer than twenty providers per request. A health insurer shall disclose the applicable provider-per-request limit to the enrollee, provide the cost-sharing information in paper form, and mail the cost-sharing information no later than two business days after receiving a request without a subscription or other fee.</span></p><p dir="ltr" class="s2083284Statute"><span class="s2083284DefaultParagraphFont">An enrollee may request to receive cost-sharing information through other methods, including phone or e-mail, as long as the enrollee agrees to the disclosure method and the required cost-sharing information request is fulfilled at least as rapidly as required by the paper method.</span></p><p dir="ltr" class="s2083284Normal"><span xml:space="preserve" class="s2083284000000"> </span></p><p dir="ltr" class="s2083284NoIndent"><span xml:space="preserve" class="s2083284DefaultParagraphFont-000001">Source: </span><span class="s2083284SCL">SL 2021, ch 213, § 4.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml" lang="en-US"><head><meta charset="UTF-8"><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17K - HEALTH CARE COST TRANSPARENCY</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s2083285Normal { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083285SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083285CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2083285Statute { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083285DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083285StatuteNumber1 { margin-left: 0.75in; text-indent: -0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } p.s2083285StatuteNumber2 { margin-left: 1.25in; text-indent: -0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083285000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083285NoIndent { text-indent: 0.00in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083285DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083285SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style><meta name="viewport" content="width=device-width, initial-scale=1"><meta name="twitter:card" content="summary"><meta property="og:title" content="SD 58-17K-5 - Prescription drug file--Required public disclosure--Method, format, and updates."><meta property="og:description" content="SDLRC Codified Law 58-17K-5 - Prescription drug file--Required public disclosure--Method, format, and updates."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-17K-5"><meta property="og:image" content="https://lawmakerdocuments.blob.core.usgovcloudapi.net/photos/logoshape.webp"><meta property="og:site_name" content="South Dakota Legislature"></head><body><div><p dir="ltr" class="s2083285Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-5" rel="noopener"><span class="s2083285SENU">58-17K-5</span></a><span xml:space="preserve" class="s2083285SENU">. </span><span xml:space="preserve" class="s2083285CL">Prescription drug file--Required public disclosure--Method, format, and updates. </span></p><p dir="ltr" class="s2083285Statute"><span class="s2083285DefaultParagraphFont">A health insurer shall make available to the public on a website a machine-readable prescription drug file that includes:</span></p><p dir="ltr" class="s2083285StatuteNumber1"><span class="s2083285DefaultParagraphFont">(1)    A health insurance oversight identifier or employer identification number;</span></p><p dir="ltr" class="s2083285StatuteNumber1"><span class="s2083285DefaultParagraphFont">(2)    The NDC and the proprietary and nonproprietary name assigned to the NDC by the Food and Drug Administration;</span></p><p dir="ltr" class="s2083285StatuteNumber1"><span class="s2083285DefaultParagraphFont">(3)    A negotiated rate that is:</span></p><p dir="ltr" class="s2083285StatuteNumber2"><span class="s2083285DefaultParagraphFont">(a)    Reflected as a dollar amount by an in-network provider, including an in-network pharmacy or other prescription drug dispenser;</span></p><p dir="ltr" class="s2083285StatuteNumber2"><span class="s2083285DefaultParagraphFont">(b)    Associated with the national provider identifier, tax identification number, or place of service code; and</span></p><p dir="ltr" class="s2083285StatuteNumber2"><span class="s2083285DefaultParagraphFont">(c)    Associated with the last date of the contract term; and</span></p><p dir="ltr" class="s2083285StatuteNumber1"><span class="s2083285DefaultParagraphFont">(4)    Historical net prices that are:</span></p><p dir="ltr" class="s2083285StatuteNumber2"><span class="s2083285DefaultParagraphFont">(a)    Reflected as a dollar amount by an in-network provider, including an in-network pharmacy or other prescription drug dispenser;</span></p><p dir="ltr" class="s2083285StatuteNumber2"><span class="s2083285DefaultParagraphFont">(b)    Associated with the national provider identifier, tax identification number, or place of service code; and</span></p><p dir="ltr" class="s2083285StatuteNumber2"><span class="s2083285DefaultParagraphFont">(c)    Associated with the ninety-day time period that begins one hundred eighty days prior to publication date of the machine-readable file for each provider-specific historical net price that applies to each NDC, unless a health insurer must omit data in relation to a particular NDC and provider when compliance with this subsection would require the health insurer to report payment of historical net prices calculated using fewer than twenty different claims for payments.</span></p><p dir="ltr" class="s2083285Statute"><span xml:space="preserve" class="s2083285DefaultParagraphFont">The prescription drug file shall be available in the method and format as promulgated by the director in rule pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-26" rel="noopener"><span class="s2083285DefaultParagraphFont">1-26</span></a><span class="s2083285DefaultParagraphFont">. The prescription drug file shall be publicly available and accessible to any person free of charge and without conditions, including the establishment of a user account, password, or other credentials, or submission of personally identifiable information to access the file.</span></p><p dir="ltr" class="s2083285Statute"><span class="s2083285DefaultParagraphFont">A health insurer shall update the prescription drug file monthly and indicate the date the file was most recently updated.</span></p><p dir="ltr" class="s2083285Normal"><span xml:space="preserve" class="s2083285000000"> </span></p><p dir="ltr" class="s2083285NoIndent"><span xml:space="preserve" class="s2083285DefaultParagraphFont-000001">Source: </span><span class="s2083285SCL">SL 2021, ch 213, § 5.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml" lang="en-US"><head><meta charset="UTF-8"><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17K - HEALTH CARE COST TRANSPARENCY</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s2083286Normal { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083286SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083286CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2083286Statute { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083286DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2083286000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083286NoIndent { text-indent: 0.00in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083286DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083286SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style><meta name="viewport" content="width=device-width, initial-scale=1"><meta name="twitter:card" content="summary"><meta property="og:title" content="SD 58-17K-6 - Cost-sharing information or prescription drug file--Third party contract to provide information--Health insurer responsible."><meta property="og:description" content="SDLRC Codified Law 58-17K-6 - Cost-sharing information or prescription drug file--Third party contract to provide information--Health insurer responsible."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-17K-6"><meta property="og:image" content="https://lawmakerdocuments.blob.core.usgovcloudapi.net/photos/logoshape.webp"><meta property="og:site_name" content="South Dakota Legislature"></head><body><div><p dir="ltr" class="s2083286Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-6" rel="noopener"><span class="s2083286SENU">58-17K-6</span></a><span xml:space="preserve" class="s2083286SENU">. </span><span xml:space="preserve" class="s2083286CL">Cost-sharing information or prescription drug file--Third party contract to provide information--Health insurer responsible. </span></p><p dir="ltr" class="s2083286Statute"><span class="s2083286DefaultParagraphFont">A health insurer may enter into a written agreement with a third-party administrator, health care claims clearinghouse, pharmacy benefit manager, or other third party to provide the required cost-sharing information or prescription drug file in compliance with this chapter. If a health insurer chooses to enter into an agreement and the contracted party fails to provide the information or file, the health insurer is in violation of this chapter.</span></p><p dir="ltr" class="s2083286Normal"><span xml:space="preserve" class="s2083286000000"> </span></p><p dir="ltr" class="s2083286NoIndent"><span xml:space="preserve" class="s2083286DefaultParagraphFont-000001">Source: </span><span class="s2083286SCL">SL 2021, ch 213, § 6.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml" lang="en-US"><head><meta charset="UTF-8"><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17K - HEALTH CARE COST TRANSPARENCY</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s2083287Normal { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083287SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083287CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2083287Statute { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083287DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083287StatuteNumber1 { margin-left: 0.75in; text-indent: -0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083287000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083287NoIndent { text-indent: 0.00in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083287DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083287SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style><meta name="viewport" content="width=device-width, initial-scale=1"><meta name="twitter:card" content="summary"><meta property="og:title" content="SD 58-17K-7 - Acting in good faith--Error or omission--Reliance on other entity."><meta property="og:description" content="SDLRC Codified Law 58-17K-7 - Acting in good faith--Error or omission--Reliance on other entity."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-17K-7"><meta property="og:image" content="https://lawmakerdocuments.blob.core.usgovcloudapi.net/photos/logoshape.webp"><meta property="og:site_name" content="South Dakota Legislature"></head><body><div><p dir="ltr" class="s2083287Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-7" rel="noopener"><span class="s2083287SENU">58-17K-7</span></a><span xml:space="preserve" class="s2083287SENU">. </span><span xml:space="preserve" class="s2083287CL">Acting in good faith--Error or omission--Reliance on other entity. </span></p><p dir="ltr" class="s2083287Statute"><span class="s2083287DefaultParagraphFont">A health insurer acting in good faith and with reasonable diligence is not in violation of this chapter solely because the health insurer:</span></p><p dir="ltr" class="s2083287StatuteNumber1"><span class="s2083287DefaultParagraphFont">(1)    Makes an error or omission in a disclosure required in this chapter, provided the health insurer corrects the information as soon as practicable; or</span></p><p dir="ltr" class="s2083287StatuteNumber1"><span class="s2083287DefaultParagraphFont">(2)    Maintains an internet website that is temporarily inaccessible, provided the health insurer makes the information available as soon as practicable.</span></p><p dir="ltr" class="s2083287Statute"><span class="s2083287DefaultParagraphFont">To the extent this chapter requires a health insurer to obtain information from any other entity, the health insurer does not fail to comply with this chapter if the health insurer relies in good faith on the information from the other entity, unless the health insurer knows, or reasonably should know, the information is incomplete or inaccurate.</span></p><p dir="ltr" class="s2083287Normal"><span xml:space="preserve" class="s2083287000000"> </span></p><p dir="ltr" class="s2083287NoIndent"><span xml:space="preserve" class="s2083287DefaultParagraphFont-000001">Source: </span><span class="s2083287SCL">SL 2021, ch 213, § 7.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml" lang="en-US"><head><meta charset="UTF-8"><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17K - HEALTH CARE COST TRANSPARENCY</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s2083288Normal { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083288SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083288CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2083288Statute { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083288DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2083288000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083288NoIndent { text-indent: 0.00in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083288DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083288SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style><meta name="viewport" content="width=device-width, initial-scale=1"><meta name="twitter:card" content="summary"><meta property="og:title" content="SD 58-17K-8 - Compliance with applicable laws required."><meta property="og:description" content="SDLRC Codified Law 58-17K-8 - Compliance with applicable laws required."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-17K-8"><meta property="og:image" content="https://lawmakerdocuments.blob.core.usgovcloudapi.net/photos/logoshape.webp"><meta property="og:site_name" content="South Dakota Legislature"></head><body><div><p dir="ltr" class="s2083288Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-8" rel="noopener"><span class="s2083288SENU">58-17K-8</span></a><span xml:space="preserve" class="s2083288SENU">. </span><span xml:space="preserve" class="s2083288CL">Compliance with applicable laws required. </span></p><p dir="ltr" class="s2083288Statute"><span class="s2083288DefaultParagraphFont">Nothing in this chapter alters or affects a health insurer's duty to comply with requirements under applicable state and federal laws, including those governing accessibility, privacy, or security of information required to be disclosed under this chapter, or those governing the ability of properly authorized representatives to access enrollee information held by a health insurer.</span></p><p dir="ltr" class="s2083288Normal"><span xml:space="preserve" class="s2083288000000"> </span></p><p dir="ltr" class="s2083288NoIndent"><span xml:space="preserve" class="s2083288DefaultParagraphFont-000001">Source: </span><span class="s2083288SCL">SL 2021, ch 213, § 8.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml" lang="en-US"><head><meta charset="UTF-8"><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17K - HEALTH CARE COST TRANSPARENCY</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s2083289Normal { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083289SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083289CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2083289Statute { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083289DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083289StatuteNumber1 { margin-left: 0.75in; text-indent: -0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083289000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083289NoIndent { text-indent: 0.00in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083289DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083289SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style><meta name="viewport" content="width=device-width, initial-scale=1"><meta name="twitter:card" content="summary"><meta property="og:title" content="SD 58-17K-9 - Applicability to certain plans."><meta property="og:description" content="SDLRC Codified Law 58-17K-9 - Applicability to certain plans."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-17K-9"><meta property="og:image" content="https://lawmakerdocuments.blob.core.usgovcloudapi.net/photos/logoshape.webp"><meta property="og:site_name" content="South Dakota Legislature"></head><body><div><p dir="ltr" class="s2083289Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-9" rel="noopener"><span class="s2083289SENU">58-17K-9</span></a><span xml:space="preserve" class="s2083289SENU">. </span><span xml:space="preserve" class="s2083289CL">Applicability to certain plans. </span></p><p dir="ltr" class="s2083289Statute"><span class="s2083289DefaultParagraphFont">Nothing in this chapter applies to:</span></p><p dir="ltr" class="s2083289StatuteNumber1"><span class="s2083289DefaultParagraphFont">(1)    A grandfathered health plan;</span></p><p dir="ltr" class="s2083289StatuteNumber1"><span class="s2083289DefaultParagraphFont">(2)    A health reimbursement arrangement or other account-based group health plan as defined in 29 CFR 2590.715-2711(d)(6) as of January 1, 2020;</span></p><p dir="ltr" class="s2083289StatuteNumber1"><span class="s2083289DefaultParagraphFont">(3)    A short term limited duration plan;</span></p><p dir="ltr" class="s2083289StatuteNumber1"><span class="s2083289DefaultParagraphFont">(4)    Accident insurance;</span></p><p dir="ltr" class="s2083289StatuteNumber1"><span class="s2083289DefaultParagraphFont">(5)    Credit insurance;</span></p><p dir="ltr" class="s2083289StatuteNumber1"><span class="s2083289DefaultParagraphFont">(6)    Disability income insurance;</span></p><p dir="ltr" class="s2083289StatuteNumber1"><span class="s2083289DefaultParagraphFont">(7)    Specified disease insurance;</span></p><p dir="ltr" class="s2083289StatuteNumber1"><span class="s2083289DefaultParagraphFont">(8)    Dental insurance;</span></p><p dir="ltr" class="s2083289StatuteNumber1"><span class="s2083289DefaultParagraphFont">(9)    Vision insurance;</span></p><p dir="ltr" class="s2083289StatuteNumber1"><span class="s2083289DefaultParagraphFont">(10)    Coverage issued as a supplement to liability insurance;</span></p><p dir="ltr" class="s2083289StatuteNumber1"><span class="s2083289DefaultParagraphFont">(11)    A medical payment under automobile or homeowner's insurance;</span></p><p dir="ltr" class="s2083289StatuteNumber1"><span class="s2083289DefaultParagraphFont">(12)    Insurance under which benefits are payable with or without regard to fault and that is statutorily required to be contained in any liability policy or equivalent self-insurance;</span></p><p dir="ltr" class="s2083289StatuteNumber1"><span class="s2083289DefaultParagraphFont">(13)    Hospital income or indemnity insurance;</span></p><p dir="ltr" class="s2083289StatuteNumber1"><span class="s2083289DefaultParagraphFont">(14)    Long-term care insurance; and</span></p><p dir="ltr" class="s2083289StatuteNumber1"><span class="s2083289DefaultParagraphFont">(15)    Medicare supplement insurance.</span></p><p dir="ltr" class="s2083289Normal"><span xml:space="preserve" class="s2083289000000"> </span></p><p dir="ltr" class="s2083289NoIndent"><span xml:space="preserve" class="s2083289DefaultParagraphFont-000001">Source: </span><span class="s2083289SCL">SL 2021, ch 213, § 9.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml" lang="en-US"><head><meta charset="UTF-8"><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17K - HEALTH CARE COST TRANSPARENCY</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s2083290Normal { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083290SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083290CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2083290Statute { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083290DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083290StatuteNumber1 { margin-left: 0.75in; text-indent: -0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083290000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083290NoIndent { text-indent: 0.00in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083290DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083290SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style><meta name="viewport" content="width=device-width, initial-scale=1"><meta name="twitter:card" content="summary"><meta property="og:title" content="SD 58-17K-10 - Rules and regulations."><meta property="og:description" content="SDLRC Codified Law 58-17K-10 - Rules and regulations."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-17K-10"><meta property="og:image" content="https://lawmakerdocuments.blob.core.usgovcloudapi.net/photos/logoshape.webp"><meta property="og:site_name" content="South Dakota Legislature"></head><body><div><p dir="ltr" class="s2083290Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-10" rel="noopener"><span class="s2083290SENU">58-17K-10</span></a><span xml:space="preserve" class="s2083290SENU">. </span><span xml:space="preserve" class="s2083290CL">Rules and regulations. </span></p><p dir="ltr" class="s2083290Statute"><span xml:space="preserve" class="s2083290DefaultParagraphFont">The director shall promulgate rules, pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-26" rel="noopener"><span class="s2083290DefaultParagraphFont">1-26</span></a><span class="s2083290DefaultParagraphFont">, for the following:</span></p><p dir="ltr" class="s2083290StatuteNumber1"><span class="s2083290DefaultParagraphFont">(1)    The definition of terms;</span></p><p dir="ltr" class="s2083290StatuteNumber1"><span class="s2083290DefaultParagraphFont">(2)    Required cost-sharing liability disclosures;</span></p><p dir="ltr" class="s2083290StatuteNumber1"><span class="s2083290DefaultParagraphFont">(3)    The method and format requirements for disclosures;</span></p><p dir="ltr" class="s2083290StatuteNumber1"><span class="s2083290DefaultParagraphFont">(4)    Calculations pertaining to information, disclosure, and historical net prices under this chapter;</span></p><p dir="ltr" class="s2083290StatuteNumber1"><span class="s2083290DefaultParagraphFont">(5)    Required information, including bundled payment arrangements, preventive services, and accumulated amounts;</span></p><p dir="ltr" class="s2083290StatuteNumber1"><span class="s2083290DefaultParagraphFont">(6)    The applicability of this chapter to certain plans; and</span></p><p dir="ltr" class="s2083290StatuteNumber1"><span class="s2083290DefaultParagraphFont">(7)    If any federal standards are in place which would require additional steps to meet those standards beyond what is required by this chapter, additional rules to require the price transparency in this state to minimally meet the federal standards.</span></p><p dir="ltr" class="s2083290Normal"><span xml:space="preserve" class="s2083290000000"> </span></p><p dir="ltr" class="s2083290NoIndent"><span xml:space="preserve" class="s2083290DefaultParagraphFont-000001">Source: </span><span class="s2083290SCL">SL 2021, ch 213, § 10.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml" lang="en-US"><head><meta charset="UTF-8"><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17K - HEALTH CARE COST TRANSPARENCY</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s2083291Normal { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083291SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083291CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2083291Statute { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083291DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2083291000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083291NoIndent { text-indent: 0.00in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2083291DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2083291SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } body { text-decoration-skip-ink: none; } </style><meta name="viewport" content="width=device-width, initial-scale=1"><meta name="twitter:card" content="summary"><meta property="og:title" content="SD 58-17K-11 - Plan years effective."><meta property="og:description" content="SDLRC Codified Law 58-17K-11 - Plan years effective."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-17K-11"><meta property="og:image" content="https://lawmakerdocuments.blob.core.usgovcloudapi.net/photos/logoshape.webp"><meta property="og:site_name" content="South Dakota Legislature"></head><body><div><p dir="ltr" class="s2083291Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-11" rel="noopener"><span class="s2083291SENU">58-17K-11</span></a><span xml:space="preserve" class="s2083291SENU">. </span><span xml:space="preserve" class="s2083291CL">Plan years effective. </span></p><p dir="ltr" class="s2083291Statute"><span xml:space="preserve" class="s2083291DefaultParagraphFont">The provisions of § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-5" rel="noopener"><span class="s2083291DefaultParagraphFont">58-17K-5</span></a><span xml:space="preserve" class="s2083291DefaultParagraphFont"> are effective for plan years beginning on or after January 1, 2022. The provisions of §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-2" rel="noopener"><span class="s2083291DefaultParagraphFont">58-17K-2</span></a><span xml:space="preserve" class="s2083291DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17K-4" rel="noopener"><span class="s2083291DefaultParagraphFont">58-17K-4</span></a><span class="s2083291DefaultParagraphFont">, inclusive, are effective for plan years beginning on or after January 1, 2024.</span></p><p dir="ltr" class="s2083291Normal"><span xml:space="preserve" class="s2083291000000"> </span></p><p dir="ltr" class="s2083291NoIndent"><span xml:space="preserve" class="s2083291DefaultParagraphFont-000001">Source: </span><span class="s2083291SCL">SL 2021, ch 213, § 11.</span></p></div></body></html>