<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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.sef9d0fccb52046f6b17110c7a8a63d9aNormal { 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.sef9d0fccb52046f6b17110c7a8a63d9aHG4 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.sef9d0fccb52046f6b17110c7a8a63d9aHG4C { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.sef9d0fccb52046f6b17110c7a8a63d9aNormal-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.sef9d0fccb52046f6b17110c7a8a63d9a000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.sef9d0fccb52046f6b17110c7a8a63d9aB { 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 58-29E - PHARMACY BENEFITS MANAGEMENT"><meta property="og:description" content="SDLRC Codified Law 58-29E - PHARMACY BENEFITS MANAGEMENT"><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes/58-29E"><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="sef9d0fccb52046f6b17110c7a8a63d9aNormal"><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aHG4">CHAPTER </span><a href="https://sdlegislature.gov/Statutes?Statute=58-29E" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E</span></a></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aNormal"><span class="sef9d0fccb52046f6b17110c7a8a63d9aHG4C">PHARMACY BENEFITS MANAGEMENT</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aNormal-000000"><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9a000001"> </span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-1" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-1</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Definitions.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-2" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-2</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Licensure requirement--Pharmacy benefit manager.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-3" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-3</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Performance of duties--Good faith.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-4" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-4</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Request for disclosure of rebates and other revenues.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-5" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-5</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Permission to contact covered individual.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-6" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-6</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Disclosure of rebates and other revenues--Confidentiality.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-7" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-7</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Annual audit of pharmacy benefit manager authorized.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-7.1" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-7.1</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Prohibition on publication or disclosure of information.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-8" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-8</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Substitute drug--Dispensation.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-8.1" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-8.1</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Provision of information to a patient.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-9" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-9</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Rules--Content.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-10" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-10</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Enforcement of chapter--Civil action.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-11" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-11</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Repealed.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-12" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-12</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Charging cost share that exceeds amount retained by pharmacy--Prohibition.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-13" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-13</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Certain claims adjustments prohibited.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-14" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-14</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Adjustment of claim due to error in adjudication permitted.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-15" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-15</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Discrimination prohibited--340B entity--Exclusions.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-15.1" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-15.1</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Discrimination prohibited--Treble damages.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-16" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-16</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Prohibition regarding the assessment or collection of fees.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-17" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-17</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Placement on a maximum allowable cost list--Requirements--Promulgation of rules.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-18" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-18</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Duties--Pharmacy benefit manager.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-19" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-19</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Reimbursement.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-20" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-20</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Information to be disclosed--Division request.</span></p><p dir="ltr" class="sef9d0fccb52046f6b17110c7a8a63d9aB"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-21" rel="noopener"><span class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">58-29E-21</span></a><span xml:space="preserve" class="sef9d0fccb52046f6b17110c7a8a63d9aDefaultParagraphFont">    Licensure--Denial--Failure to provide information.</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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s80cb363fdcb44e4b8690d7d97dda6a9aNormal { 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.s80cb363fdcb44e4b8690d7d97dda6a9aSENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s80cb363fdcb44e4b8690d7d97dda6a9aCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s80cb363fdcb44e4b8690d7d97dda6a9aStatute { text-indent: 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p.s80cb363fdcb44e4b8690d7d97dda6a9aNoIndent { 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.s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s80cb363fdcb44e4b8690d7d97dda6a9aSCL { 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 58-29E-1 - Definitions."><meta property="og:description" content="SDLRC Codified Law 58-29E-1 - Definitions."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes/58-29E-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="s80cb363fdcb44e4b8690d7d97dda6a9aNormal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-1" rel="noopener"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aSENU">58-29E-1</span></a><span xml:space="preserve" class="s80cb363fdcb44e4b8690d7d97dda6a9aSENU">. </span><span class="s80cb363fdcb44e4b8690d7d97dda6a9aCL">Definitions.</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatute"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">Terms used in this chapter mean:</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span xml:space="preserve" class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(1)    "Brand name," the same as set forth in § </span><a href="https://sdlegislature.gov/Statutes?Statute=36-11-2" rel="noopener"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">36-11-2</span></a><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(2)    "Covered individual," a member, participant, enrollee, contract holder, policy holder, or beneficiary of a third-party payor who is provided health coverage by the third-party payor. The term includes a dependent or other individual provided health coverage through a policy, contract, or plan for a covered individual;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(3)    "Generic drug," a chemically equivalent copy of a brand name drug with an expired patent;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span xml:space="preserve" class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(4)    "Health benefit plan," the same as set forth in § </span><a href="https://sdlegislature.gov/Statutes?Statute=58-17F-2" rel="noopener"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">58-17F-2</span></a><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span xml:space="preserve" class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(5)    "Health carrier," the same as set forth in § </span><a href="https://sdlegislature.gov/Statutes?Statute=58-17F-1" rel="noopener"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">58-17F-1</span></a><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span xml:space="preserve" class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(6)    "Interchangeable biological product," the same as set forth in § </span><a href="https://sdlegislature.gov/Statutes?Statute=36-11-2" rel="noopener"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">36-11-2</span></a><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(7)    "Maximum allowable cost," the maximum amount that a pharmacy may be reimbursed, as set by a pharmacy benefit manager or a third-party payor, for a brand name or a generic drug, an interchangeable biological product, or any other prescription drug and which may include:</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(a)    The average acquisition cost;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(b)    The national average acquisition cost;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(c)    The average manufacturer price;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(d)    The average wholesale price;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(e)    The brand effective rate;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(f)    The generic effective rate;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(g)    Discount indexing;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(h)    Federal upper limits;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(i)    The wholesale acquisition cost; and</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(j)    Any other term used by a pharmacy benefit manager or a health carrier to establish reimbursement rates for a pharmacy;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(8)    "Maximum allowable cost list," a list of prescription drugs that:</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(a)    Includes the maximum allowable cost for each prescription drug; and</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(b)    Is used, directly or indirectly, by a pharmacy benefit manager;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(9)    "Pharmaceutical manufacturer," any person engaged in the business of preparing, producing, converting, processing, packaging, labeling, or distributing a prescription drug, but not including a wholesale distributor or dispenser;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span xml:space="preserve" class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(10)    "Pharmacist," the same as set forth in § </span><a href="https://sdlegislature.gov/Statutes?Statute=36-11-2" rel="noopener"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">36-11-2</span></a><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span xml:space="preserve" class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(11)    "Pharmacy," the same as set forth in § </span><a href="https://sdlegislature.gov/Statutes?Statute=36-11-2" rel="noopener"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">36-11-2</span></a><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(12)    "Pharmacy benefit management," the procurement of prescription drugs at a negotiated rate for dispensation within this state to covered individuals, the administration or management of prescription drug benefits provided by a third-party payor for the benefit of covered individuals, or any of the following services provided with regard to the administration of pharmacy benefits:</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(a)    Mail service pharmacy;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(b)    Claims processing, retail network management, and payment of claims to pharmacies for prescription drugs dispensed to covered individuals;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(c)    Clinical formulary development and management services;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(d)    Rebate contracting and administration;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(e)    Certain patient compliance, therapeutic intervention, and generic substitution programs; and</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(f)    Disease management programs involving prescription drug utilization;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(13)    "Pharmacy benefit management fee," a fee that covers the cost of providing pharmacy benefit management, but does not exceed the value of the service performed by the pharmacy benefit manager;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(14)    "Pharmacy benefit manager," a person that performs pharmacy benefit management, pursuant to a contract or other relationship with a third-party payor and includes:</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(a)    A person acting in a contractual or employment relationship for a pharmacy benefit manager while providing pharmacy benefit management for a third-party payor; and</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(b)    A mail service pharmacy;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(15)    "Pharmacy benefit manager affiliate," a pharmacy that, or a pharmacist who, directly or indirectly, through one or more intermediaries, owns or controls, is owned and controlled by, or is under common ownership or control of, a pharmacy benefit manager;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(16)    "Pharmacy network," pharmacies that have contracted with a pharmacy benefit manager to dispense or sell prescription drugs to covered individuals under a health benefit plan for which the prescription drug benefit is managed by a pharmacy benefit manager;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(17)    "Prescription drug," a drug classified by the United States Food and Drug Administration as requiring a prescription by a health care practitioner, prior to being administered or dispensed to a patient, and including interchangeable biological products, brand names, and generic drugs;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(18)    "Prescription drug benefit, a health benefit plan providing third-party payment or prepayment for prescription drugs;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span xml:space="preserve" class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(19)    "Prescription drug order, the same as set forth in § </span><a href="https://sdlegislature.gov/Statutes?Statute=36-11-2" rel="noopener"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">36-11-2</span></a><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(20)    "Proprietary information," information on pricing, costs, revenue, taxes, market share, negotiating strategies, customers, and personnel held by a private entity and used for that private entity's business purposes;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(21)    "Rebate," a discount or other negotiated price concession that is paid directly or indirectly to a pharmacy benefit manager by a pharmaceutical manufacturer or by an entity in the prescription drug supply chain, other than a covered individual, and which is:</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(a)    Based on a pharmaceutical manufacturer's list price for a prescription drug;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(b)    Based on utilization;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(c)    Designed to maintain, for the pharmacy benefit manager, a net price for a prescription drug, during a specified period of time, in the event the pharmaceutical manufacturer's list price increases; or</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(d)    Based on estimates regarding the quantity of a prescribed drug that will be dispensed by a pharmacy to covered individuals;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(22)    "Spread pricing," an amount charged or claimed by a pharmacy benefit manager that is in excess of the ingredient cost for a dispensed prescription drug, plus a dispensing fee paid directly or indirectly to a pharmacy, pharmacist, or other provider, on behalf of the third-party payor, less a pharmacy benefit management fee;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(23)    "Third-party payor," any entity, other than a covered individual, a covered individual's representative, or a healthcare provider, which is responsible for any amount of reimbursement for a prescription drug benefit, provided the term includes a health carrier and a health benefit plan;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(24)    "340B drug," a drug purchased through the 340B drug discount program by a 340B entity;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(25)    "340B drug discount program," a program that imposes limitations on the prices of drugs purchased by covered entities, in accordance with 42 U.S.C. § 256b (January 1, 2024);</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(26)    "340B entity," a covered entity as defined in 42 U.S.C. § 256b(a)(4) (January 1, 2024);</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span xml:space="preserve" class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(27)    "Trade secret," the same as set forth in § </span><a href="https://sdlegislature.gov/Statutes?Statute=37-29-1" rel="noopener"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">37-29-1</span></a><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(28)    "Unaffiliated pharmacy," a dispensing pharmacy that is not:</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(a)    Owned, in whole or in part, by a pharmacy benefit manager;</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(b)    A subsidiary of a pharmacy benefit manager; or</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber2"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(c)    An affiliate of a pharmacy benefit manager; and</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aStatuteNumber1"><span xml:space="preserve" class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">(29)    "Wholesale distributor," the same as set forth in § </span><a href="https://sdlegislature.gov/Statutes?Statute=36-11A-25" rel="noopener"><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">36-11A-25</span></a><span class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont">.</span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aNormal"><span xml:space="preserve" class="s80cb363fdcb44e4b8690d7d97dda6a9a000000"> </span></p><p dir="ltr" class="s80cb363fdcb44e4b8690d7d97dda6a9aNoIndent"><span xml:space="preserve" class="s80cb363fdcb44e4b8690d7d97dda6a9aDefaultParagraphFont-000001">Source: </span><span class="s80cb363fdcb44e4b8690d7d97dda6a9aSCL">SL 2004, ch 311, § 1; SL 2023, ch 166, § 1; SL 2024, ch 203, § 2, eff. Jan. 1, 2025.</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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s875a1766a0c14b4b99a1abd8bc2b9aa9Normal { 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.s875a1766a0c14b4b99a1abd8bc2b9aa9SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s875a1766a0c14b4b99a1abd8bc2b9aa9CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s875a1766a0c14b4b99a1abd8bc2b9aa9Statute { 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.s875a1766a0c14b4b99a1abd8bc2b9aa9DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s875a1766a0c14b4b99a1abd8bc2b9aa9000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s875a1766a0c14b4b99a1abd8bc2b9aa9NoIndent { 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.s875a1766a0c14b4b99a1abd8bc2b9aa9DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s875a1766a0c14b4b99a1abd8bc2b9aa9SCL { 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 58-29E-2 - Licensure requirement--Pharmacy benefit manager."><meta property="og:description" content="SDLRC Codified Law 58-29E-2 - Licensure requirement--Pharmacy benefit manager."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-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="s875a1766a0c14b4b99a1abd8bc2b9aa9Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-2" rel="noopener"><span class="s875a1766a0c14b4b99a1abd8bc2b9aa9SENU">58-29E-2</span></a><span xml:space="preserve" class="s875a1766a0c14b4b99a1abd8bc2b9aa9SENU">. </span><span class="s875a1766a0c14b4b99a1abd8bc2b9aa9CL">Licensure requirement--Pharmacy benefit manager.</span></p><p dir="ltr" class="s875a1766a0c14b4b99a1abd8bc2b9aa9Statute"><span xml:space="preserve" class="s875a1766a0c14b4b99a1abd8bc2b9aa9DefaultParagraphFont">A person may not act as a pharmacy benefit manager in this state without a license to operate as a third party administrator pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes?Statute=58-29D" rel="noopener"><span class="s875a1766a0c14b4b99a1abd8bc2b9aa9DefaultParagraphFont">58-29D</span></a><span xml:space="preserve" class="s875a1766a0c14b4b99a1abd8bc2b9aa9DefaultParagraphFont">. Sections </span><a href="https://sdlegislature.gov/Statutes?Statute=58-29D" rel="noopener"><span class="s875a1766a0c14b4b99a1abd8bc2b9aa9DefaultParagraphFont">58-29D</span></a><span xml:space="preserve" class="s875a1766a0c14b4b99a1abd8bc2b9aa9DefaultParagraphFont">-26, </span><a href="https://sdlegislature.gov/Statutes?Statute=58-29D" rel="noopener"><span class="s875a1766a0c14b4b99a1abd8bc2b9aa9DefaultParagraphFont">58-29D</span></a><span xml:space="preserve" class="s875a1766a0c14b4b99a1abd8bc2b9aa9DefaultParagraphFont">-27, and </span><a href="https://sdlegislature.gov/Statutes?Statute=58-29D" rel="noopener"><span class="s875a1766a0c14b4b99a1abd8bc2b9aa9DefaultParagraphFont">58-29D</span></a><span class="s875a1766a0c14b4b99a1abd8bc2b9aa9DefaultParagraphFont">-29 do not apply to pharmacy benefits managers.</span></p><p dir="ltr" class="s875a1766a0c14b4b99a1abd8bc2b9aa9Normal"><span xml:space="preserve" class="s875a1766a0c14b4b99a1abd8bc2b9aa9000000"> </span></p><p dir="ltr" class="s875a1766a0c14b4b99a1abd8bc2b9aa9NoIndent"><span xml:space="preserve" class="s875a1766a0c14b4b99a1abd8bc2b9aa9DefaultParagraphFont-000001">Source: </span><span class="s875a1766a0c14b4b99a1abd8bc2b9aa9SCL">SL 2004, ch 311, § 2; SL 2013, ch 253, § 5; SL 2023, ch 166, § 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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s7dc398b709424da2adb98e9c492b1c04Normal { 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.s7dc398b709424da2adb98e9c492b1c04SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s7dc398b709424da2adb98e9c492b1c04CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s7dc398b709424da2adb98e9c492b1c04Statute { 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.s7dc398b709424da2adb98e9c492b1c04DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s7dc398b709424da2adb98e9c492b1c04000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s7dc398b709424da2adb98e9c492b1c04NoIndent { 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.s7dc398b709424da2adb98e9c492b1c04DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s7dc398b709424da2adb98e9c492b1c04SCL { 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 58-29E-3 - Performance of duties--Good faith."><meta property="og:description" content="SDLRC Codified Law 58-29E-3 - Performance of duties--Good faith."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-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="s7dc398b709424da2adb98e9c492b1c04Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-3" rel="noopener"><span class="s7dc398b709424da2adb98e9c492b1c04SENU">58-29E-3</span></a><span xml:space="preserve" class="s7dc398b709424da2adb98e9c492b1c04SENU">. </span><span class="s7dc398b709424da2adb98e9c492b1c04CL">Performance of duties--Good faith.</span></p><p dir="ltr" class="s7dc398b709424da2adb98e9c492b1c04Statute"><span class="s7dc398b709424da2adb98e9c492b1c04DefaultParagraphFont">Each pharmacy benefit manager shall perform its duties in good faith and with fair dealing toward the third-party payor.</span></p><p dir="ltr" class="s7dc398b709424da2adb98e9c492b1c04Normal"><span xml:space="preserve" class="s7dc398b709424da2adb98e9c492b1c04000000"> </span></p><p dir="ltr" class="s7dc398b709424da2adb98e9c492b1c04NoIndent"><span xml:space="preserve" class="s7dc398b709424da2adb98e9c492b1c04DefaultParagraphFont-000001">Source: </span><span class="s7dc398b709424da2adb98e9c492b1c04SCL">SL 2004, ch 311, § 3; SL 2023, ch 166, § 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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s2d3ff39135d943fca889eb381ca95a8eNormal { 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.s2d3ff39135d943fca889eb381ca95a8eSENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2d3ff39135d943fca889eb381ca95a8eCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2d3ff39135d943fca889eb381ca95a8eStatute { 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.s2d3ff39135d943fca889eb381ca95a8eDefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2d3ff39135d943fca889eb381ca95a8eStatuteNumber1 { 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.s2d3ff39135d943fca889eb381ca95a8e000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2d3ff39135d943fca889eb381ca95a8eNoIndent { 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.s2d3ff39135d943fca889eb381ca95a8eDefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2d3ff39135d943fca889eb381ca95a8eSCL { 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 58-29E-4 - Request for disclosure of rebates and other revenues."><meta property="og:description" content="SDLRC Codified Law 58-29E-4 - Request for disclosure of rebates and other revenues."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-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="s2d3ff39135d943fca889eb381ca95a8eNormal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-4" rel="noopener"><span class="s2d3ff39135d943fca889eb381ca95a8eSENU">58-29E-4</span></a><span xml:space="preserve" class="s2d3ff39135d943fca889eb381ca95a8eSENU">. </span><span class="s2d3ff39135d943fca889eb381ca95a8eCL">Request for disclosure of rebates and other revenues.</span></p><p dir="ltr" class="s2d3ff39135d943fca889eb381ca95a8eStatute"><span class="s2d3ff39135d943fca889eb381ca95a8eDefaultParagraphFont">A third-party payor may request that a pharmacy benefit manager, with which it has a pharmacy benefit management services contract, disclose to the third-party payor the amount of all rebate revenues and the nature, type, and amounts of all other revenues that the pharmacy benefit manager receives from each pharmaceutical manufacturer with which the pharmacy benefit manager has a contract.</span></p><p dir="ltr" class="s2d3ff39135d943fca889eb381ca95a8eStatute"><span class="s2d3ff39135d943fca889eb381ca95a8eDefaultParagraphFont">Annually, at the time of contract renewal, the pharmacy benefit manager shall disclose in writing:</span></p><p dir="ltr" class="s2d3ff39135d943fca889eb381ca95a8eStatuteNumber1"><span class="s2d3ff39135d943fca889eb381ca95a8eDefaultParagraphFont">(1)    The aggregate amount, and for a list of drugs to be specified in the contract, the specific amount, of all rebates and other retrospective utilization discounts that are received by the pharmacy benefit manager, directly or indirectly, from each pharmaceutical manufacturer, and which are earned in connection with the dispensing of prescription drugs to covered individuals of the health benefit plans issued by the third-party payor or for which the third-party payor is the designated administrator;</span></p><p dir="ltr" class="s2d3ff39135d943fca889eb381ca95a8eStatuteNumber1"><span class="s2d3ff39135d943fca889eb381ca95a8eDefaultParagraphFont">(2)    The nature, type, and amount of all other revenue received by the pharmacy benefit manager, directly or indirectly, from each pharmaceutical manufacturer, for any other products or services, provided to the pharmaceutical manufacturer by the pharmacy benefit manager, with respect to programs that the third-party payor offers or provides to its covered individuals; and</span></p><p dir="ltr" class="s2d3ff39135d943fca889eb381ca95a8eStatuteNumber1"><span class="s2d3ff39135d943fca889eb381ca95a8eDefaultParagraphFont">(3)    Any prescription drug utilization information requested by the third-party payor and relating to covered individuals.</span></p><p dir="ltr" class="s2d3ff39135d943fca889eb381ca95a8eStatute"><span class="s2d3ff39135d943fca889eb381ca95a8eDefaultParagraphFont">A pharmacy benefit manager shall, within thirty days, provide the information requested in accordance with this section.</span></p><p dir="ltr" class="s2d3ff39135d943fca889eb381ca95a8eStatute"><span class="s2d3ff39135d943fca889eb381ca95a8eDefaultParagraphFont">If requested, the information must be provided no less than once each year.</span></p><p dir="ltr" class="s2d3ff39135d943fca889eb381ca95a8eStatute"><span class="s2d3ff39135d943fca889eb381ca95a8eDefaultParagraphFont">The contract entered into between the pharmacy benefit manager and the third-party payor must set forth any fees to be charged for drug utilization reports requested by the third-party payor.</span></p><p dir="ltr" class="s2d3ff39135d943fca889eb381ca95a8eNormal"><span xml:space="preserve" class="s2d3ff39135d943fca889eb381ca95a8e000000"> </span></p><p dir="ltr" class="s2d3ff39135d943fca889eb381ca95a8eNoIndent"><span xml:space="preserve" class="s2d3ff39135d943fca889eb381ca95a8eDefaultParagraphFont-000001">Source: </span><span class="s2d3ff39135d943fca889eb381ca95a8eSCL">SL 2004, ch 311, § 4; SL 2023, ch 166, § 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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.sf489119187854fe1b0a756c0c508ef94Normal { 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.sf489119187854fe1b0a756c0c508ef94SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sf489119187854fe1b0a756c0c508ef94CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.sf489119187854fe1b0a756c0c508ef94Statute { 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.sf489119187854fe1b0a756c0c508ef94DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.sf489119187854fe1b0a756c0c508ef94000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.sf489119187854fe1b0a756c0c508ef94NoIndent { 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.sf489119187854fe1b0a756c0c508ef94DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sf489119187854fe1b0a756c0c508ef94SCL { 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 58-29E-5 - Permission to contact covered individual."><meta property="og:description" content="SDLRC Codified Law 58-29E-5 - Permission to contact covered individual."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-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="sf489119187854fe1b0a756c0c508ef94Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-5" rel="noopener"><span class="sf489119187854fe1b0a756c0c508ef94SENU">58-29E-5</span></a><span xml:space="preserve" class="sf489119187854fe1b0a756c0c508ef94SENU">. </span><span class="sf489119187854fe1b0a756c0c508ef94CL">Permission to contact covered individual.</span></p><p dir="ltr" class="sf489119187854fe1b0a756c0c508ef94Statute"><span class="sf489119187854fe1b0a756c0c508ef94DefaultParagraphFont">A pharmacy benefit manager, unless authorized pursuant to the terms of its contract with a third-party payor, may not contact any covered individual, without the express written permission of the third-party payor.</span></p><p dir="ltr" class="sf489119187854fe1b0a756c0c508ef94Normal"><span xml:space="preserve" class="sf489119187854fe1b0a756c0c508ef94000000"> </span></p><p dir="ltr" class="sf489119187854fe1b0a756c0c508ef94NoIndent"><span xml:space="preserve" class="sf489119187854fe1b0a756c0c508ef94DefaultParagraphFont-000001">Source: </span><span class="sf489119187854fe1b0a756c0c508ef94SCL">SL 2004, ch 311, § 5; SL 2023, ch 166, § 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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s4872380aec834e49a24afc83ef4d2762Normal { 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.s4872380aec834e49a24afc83ef4d2762SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s4872380aec834e49a24afc83ef4d2762CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s4872380aec834e49a24afc83ef4d2762Statute { 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.s4872380aec834e49a24afc83ef4d2762DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s4872380aec834e49a24afc83ef4d2762000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s4872380aec834e49a24afc83ef4d2762NoIndent { 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.s4872380aec834e49a24afc83ef4d2762DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s4872380aec834e49a24afc83ef4d2762SCL { 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 58-29E-6 - Disclosure of rebates and other revenues--Confidentiality."><meta property="og:description" content="SDLRC Codified Law 58-29E-6 - Disclosure of rebates and other revenues--Confidentiality."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-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="s4872380aec834e49a24afc83ef4d2762Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-6" rel="noopener"><span class="s4872380aec834e49a24afc83ef4d2762SENU">58-29E-6</span></a><span xml:space="preserve" class="s4872380aec834e49a24afc83ef4d2762SENU">. </span><span class="s4872380aec834e49a24afc83ef4d2762CL">Disclosure of rebates and other revenues--Confidentiality.</span></p><p dir="ltr" class="s4872380aec834e49a24afc83ef4d2762Statute"><span xml:space="preserve" class="s4872380aec834e49a24afc83ef4d2762DefaultParagraphFont">Except for utilization information, a third-party payor shall maintain information disclosed in response to a request under § </span><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-4" rel="noopener"><span class="s4872380aec834e49a24afc83ef4d2762DefaultParagraphFont">58-29E-4</span></a><span xml:space="preserve" class="s4872380aec834e49a24afc83ef4d2762DefaultParagraphFont"> as confidential and proprietary information, and may not use that information for any other purpose or disclose that information to any other person, except as provided in this chapter or in the pharmacy benefit management services contract between the parties.</span></p><p dir="ltr" class="s4872380aec834e49a24afc83ef4d2762Statute"><span class="s4872380aec834e49a24afc83ef4d2762DefaultParagraphFont">A third-party payor that discloses information, in violation of this section, is subject to an action for injunctive relief and is liable for any damages that are the direct and proximate result of the disclosure.</span></p><p dir="ltr" class="s4872380aec834e49a24afc83ef4d2762Statute"><span class="s4872380aec834e49a24afc83ef4d2762DefaultParagraphFont">Nothing in this section prohibits a third-party payor from disclosing confidential or proprietary information to the director, upon request. Information obtained by the director in accordance with this section is confidential and privileged, and is not open to public inspection or disclosure.</span></p><p dir="ltr" class="s4872380aec834e49a24afc83ef4d2762Normal"><span xml:space="preserve" class="s4872380aec834e49a24afc83ef4d2762000000"> </span></p><p dir="ltr" class="s4872380aec834e49a24afc83ef4d2762NoIndent"><span xml:space="preserve" class="s4872380aec834e49a24afc83ef4d2762DefaultParagraphFont-000001">Source: </span><span class="s4872380aec834e49a24afc83ef4d2762SCL">SL 2004, ch 311, § 6; SL 2023, ch 166, § 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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.sf20f2736de1b4119a9a38e3940d79af0Normal { 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.sf20f2736de1b4119a9a38e3940d79af0SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sf20f2736de1b4119a9a38e3940d79af0CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.sf20f2736de1b4119a9a38e3940d79af0Statute { 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.sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.sf20f2736de1b4119a9a38e3940d79af0StatuteNumber1 { 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.sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2 { 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; } p.sf20f2736de1b4119a9a38e3940d79af0StatuteNumber1-000000 { 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.sf20f2736de1b4119a9a38e3940d79af0000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.sf20f2736de1b4119a9a38e3940d79af0NoIndent { 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.sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sf20f2736de1b4119a9a38e3940d79af0SCL { 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 58-29E-7 - Annual audit of pharmacy benefit manager authorized."><meta property="og:description" content="SDLRC Codified Law 58-29E-7 - Annual audit of pharmacy benefit manager authorized."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-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="sf20f2736de1b4119a9a38e3940d79af0Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-7" rel="noopener"><span class="sf20f2736de1b4119a9a38e3940d79af0SENU">58-29E-7</span></a><span xml:space="preserve" class="sf20f2736de1b4119a9a38e3940d79af0SENU">. </span><span class="sf20f2736de1b4119a9a38e3940d79af0CL">Annual audit of pharmacy benefit manager authorized.</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0Statute"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">A third-party payor that has contracted with a licensed pharmacy benefit manager may audit the pharmacy benefit manager once each calendar year. The audit authorized by this section is in addition to any other statutory or contractual audit rights. As part of the audit, a third-party payor may request:</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber1"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(1)    All reimbursements paid to retail pharmacies, on a claim level, for all customers of the pharmacy benefit manager in this state, including ancillary charges, claw backs, dispensing fees, drug-specific reimbursements, other fees, rebates, and reimbursement adjustments;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber1"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(2)    Differences in reimbursement amounts paid to affiliated and unaffiliated pharmacies, including differences in dispensing fees and reimbursed ingredient costs;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber1"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(3)    Historical claims data, including:</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(a)    Acquisition costs;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber1-000000"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(b)    Administrative fees associated with claims;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(c)    Amounts paid by a covered individual;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(d)    Amounts paid by a third-party payor;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(e)    Channels, whether mail or retail;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(f)    Dispensing fees;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(g)    Formulary tiers;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(h)    Ingredient costs;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(i)    Ingredient quantity;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(j)    Sales tax;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(k)    Supply availability by the number of days; and</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(l)    Usual and customary prices; and</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber1"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(4)    Aggregate rebate amounts, received by calendar quarter, directly or indirectly from manufacturers, including rebates from other entities affiliated with or related to the pharmacy benefit manager, if those entities negotiate or contract with manufacturers.</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0Statute"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">A pharmacy benefit manager shall, within thirty days, provide the information requested in accordance with this section, together with a certification, signed by the chief executive officer or the chief financial officer of the pharmacy benefit manager, attesting to the accuracy and completeness of the information.</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0Normal"><span xml:space="preserve" class="sf20f2736de1b4119a9a38e3940d79af0000001"> </span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0NoIndent"><span xml:space="preserve" class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont-000002">Source: </span><span class="sf20f2736de1b4119a9a38e3940d79af0SCL">SL 2004, ch 311, § 7; SL 2023, ch 166, § 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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s188c1165e6454b0fae13771c76826810Normal { 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.s188c1165e6454b0fae13771c76826810SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s188c1165e6454b0fae13771c76826810CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s188c1165e6454b0fae13771c76826810Statute { 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.s188c1165e6454b0fae13771c76826810DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s188c1165e6454b0fae13771c76826810StatuteNumber1 { 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.s188c1165e6454b0fae13771c76826810StatuteNumber1-000000 { margin-left: 0; 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.s188c1165e6454b0fae13771c76826810000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s188c1165e6454b0fae13771c76826810NoIndent { 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.s188c1165e6454b0fae13771c76826810DefaultParagraphFont-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s188c1165e6454b0fae13771c76826810SCL { 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 58-29E-7.1 - Prohibition on publication or disclosure of information."><meta property="og:description" content="SDLRC Codified Law 58-29E-7.1 - Prohibition on publication or disclosure of information."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-7.1"><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="s188c1165e6454b0fae13771c76826810Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-7.1" rel="noopener"><span class="s188c1165e6454b0fae13771c76826810SENU">58-29E-7.1</span></a><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810SENU">. </span><span class="s188c1165e6454b0fae13771c76826810CL">Prohibition on publication or disclosure of information.</span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810Statute"><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">Except as provided in chapter </span><a href="https://sdlegislature.gov/Statutes?Statute=58-17K" rel="noopener"><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">58-17K</span></a><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">, and in accordance with the audit provisions in § </span><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-7" rel="noopener"><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">58-29E-7</span></a><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">, a third-party payor that has contracted with a licensed pharmacy benefit manager may not publish, or directly or indirectly disclose:</span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810StatuteNumber1"><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">(1)    Any information that reveals the identity of a specific third-party payor or manufacturer;</span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810StatuteNumber1"><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">(2)    Prices charged for a specific drug or class of drugs;</span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810StatuteNumber1"><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">(3)    The amount of any rebates provided for a specific drug or class of drugs; or</span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810StatuteNumber1"><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">(4)    Any information that has the potential to compromise the financial, competitive, or proprietary nature of the pharmacy benefit manager's business.</span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810StatuteNumber1-000000"><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">The information referenced in § </span><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-7" rel="noopener"><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">58-29E-7</span></a><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont"> is protected from disclosure as confidential and proprietary. The information is privileged and not open to public inspection or disclosure.</span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810Statute"><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">A third-party payor that has contracted with a licensed pharmacy benefit manager shall impose the confidentiality protections set forth in § </span><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-7" rel="noopener"><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">58-29E-7</span></a><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont"> on any vendor or third party that may receive or have access to the information.</span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810Normal"><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810000001"> </span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810NoIndent"><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont-000002">Source: </span><span class="s188c1165e6454b0fae13771c76826810SCL">SL 2023, ch 166, § 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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s63218b110ad94d55ab78d228e55194bbNormal { 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.s63218b110ad94d55ab78d228e55194bbSENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s63218b110ad94d55ab78d228e55194bbCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s63218b110ad94d55ab78d228e55194bbStatute { 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.s63218b110ad94d55ab78d228e55194bbDefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s63218b110ad94d55ab78d228e55194bbDefaultParagraphFont-000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s63218b110ad94d55ab78d228e55194bb000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s63218b110ad94d55ab78d228e55194bbNoIndent { 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.s63218b110ad94d55ab78d228e55194bbDefaultParagraphFont-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s63218b110ad94d55ab78d228e55194bbSCL { 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 58-29E-8 - Substitute drug--Dispensation."><meta property="og:description" content="SDLRC Codified Law 58-29E-8 - Substitute drug--Dispensation."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-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="s63218b110ad94d55ab78d228e55194bbNormal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-8" rel="noopener"><span class="s63218b110ad94d55ab78d228e55194bbSENU">58-29E-8</span></a><span xml:space="preserve" class="s63218b110ad94d55ab78d228e55194bbSENU">. </span><span class="s63218b110ad94d55ab78d228e55194bbCL">Substitute drug--Dispensation.</span></p><p dir="ltr" class="s63218b110ad94d55ab78d228e55194bbStatute"><span class="s63218b110ad94d55ab78d228e55194bbDefaultParagraphFont">A pharmacy benefit manager may request that a lower</span><span class="s63218b110ad94d55ab78d228e55194bbDefaultParagraphFont-000000">-</span><span class="s63218b110ad94d55ab78d228e55194bbDefaultParagraphFont">priced generic and therapeutically equivalent prescription drug be dispensed to a covered individual, as a substitute for a higher</span><span class="s63218b110ad94d55ab78d228e55194bbDefaultParagraphFont-000000">-</span><span class="s63218b110ad94d55ab78d228e55194bbDefaultParagraphFont">priced prescription drug.</span></p><p dir="ltr" class="s63218b110ad94d55ab78d228e55194bbStatute"><span class="s63218b110ad94d55ab78d228e55194bbDefaultParagraphFont">If the substitute prescription drug's net cost is higher for the covered individual or the third-party payor than the originally prescribed drug, the substitution may be made only for medical reasons that benefit the covered individual.</span></p><p dir="ltr" class="s63218b110ad94d55ab78d228e55194bbStatute"><span class="s63218b110ad94d55ab78d228e55194bbDefaultParagraphFont">If a substitution is being requested pursuant to this section, the pharmacy benefit manager must obtain the approval of the prescribing health professional.</span></p><p dir="ltr" class="s63218b110ad94d55ab78d228e55194bbStatute"><span xml:space="preserve" class="s63218b110ad94d55ab78d228e55194bbDefaultParagraphFont">Nothing in this section permits the substitution of an equivalent drug product contrary to § </span><a href="https://sdlegislature.gov/Statutes?Statute=36-11-46.2" rel="noopener"><span class="s63218b110ad94d55ab78d228e55194bbDefaultParagraphFont">36-11-46.2</span></a><span class="s63218b110ad94d55ab78d228e55194bbDefaultParagraphFont">.</span></p><p dir="ltr" class="s63218b110ad94d55ab78d228e55194bbNormal"><span xml:space="preserve" class="s63218b110ad94d55ab78d228e55194bb000001"> </span></p><p dir="ltr" class="s63218b110ad94d55ab78d228e55194bbNoIndent"><span xml:space="preserve" class="s63218b110ad94d55ab78d228e55194bbDefaultParagraphFont-000002">Source: </span><span class="s63218b110ad94d55ab78d228e55194bbSCL">SL 2004, ch 311, § 8; SL 2023, ch 166, § 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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s5b5335d1980344689e401f81faca53aeNormal { 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.s5b5335d1980344689e401f81faca53aeSENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s5b5335d1980344689e401f81faca53aeCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s5b5335d1980344689e401f81faca53aeStatute { 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.s5b5335d1980344689e401f81faca53aeDefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s5b5335d1980344689e401f81faca53aeStatuteNumber1 { 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.s5b5335d1980344689e401f81faca53ae000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s5b5335d1980344689e401f81faca53aeNoIndent { 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.s5b5335d1980344689e401f81faca53aeDefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s5b5335d1980344689e401f81faca53aeSCL { 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 58-29E-8.1 - Provision of information to a patient."><meta property="og:description" content="SDLRC Codified Law 58-29E-8.1 - Provision of information to a patient."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-8.1"><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="s5b5335d1980344689e401f81faca53aeNormal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-8.1" rel="noopener"><span class="s5b5335d1980344689e401f81faca53aeSENU">58-29E-8.1</span></a><span xml:space="preserve" class="s5b5335d1980344689e401f81faca53aeSENU">. </span><span class="s5b5335d1980344689e401f81faca53aeCL">Provision of information to a patient.</span></p><p dir="ltr" class="s5b5335d1980344689e401f81faca53aeStatute"><span class="s5b5335d1980344689e401f81faca53aeDefaultParagraphFont">A pharmacy benefit manager may neither prohibit a pharmacist or pharmacy from, nor penalize a pharmacist or pharmacy for, informing a covered individual about:</span></p><p dir="ltr" class="s5b5335d1980344689e401f81faca53aeStatuteNumber1"><span class="s5b5335d1980344689e401f81faca53aeDefaultParagraphFont">(1)    The cost of a prescription drug;</span></p><p dir="ltr" class="s5b5335d1980344689e401f81faca53aeStatuteNumber1"><span class="s5b5335d1980344689e401f81faca53aeDefaultParagraphFont">(2)    The amount of reimbursement that the pharmacy will receive for dispensing the prescription drug;</span></p><p dir="ltr" class="s5b5335d1980344689e401f81faca53aeStatuteNumber1"><span class="s5b5335d1980344689e401f81faca53aeDefaultParagraphFont">(3)    The cost and clinical efficacy of a more affordable alternative prescription drug, if one is available; and</span></p><p dir="ltr" class="s5b5335d1980344689e401f81faca53aeStatuteNumber1"><span class="s5b5335d1980344689e401f81faca53aeDefaultParagraphFont">(4)    Any differential between the amount a covered individual would pay under the covered individual s prescription drug benefit and a lower price the covered individual would pay for the prescription drug, if the covered individual obtained the prescription drug without making a claim for benefits on the covered individual s prescription drug benefit.</span></p><p dir="ltr" class="s5b5335d1980344689e401f81faca53aeNormal"><span xml:space="preserve" class="s5b5335d1980344689e401f81faca53ae000000"> </span></p><p dir="ltr" class="s5b5335d1980344689e401f81faca53aeNoIndent"><span xml:space="preserve" class="s5b5335d1980344689e401f81faca53aeDefaultParagraphFont-000001">Source: </span><span class="s5b5335d1980344689e401f81faca53aeSCL">SL 2018, ch 281, § 1; SL 2023, ch 166, § 10.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2076340Normal { 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.s2076340SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2076340CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2076340Normal-000000 { 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.s2076340DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2076340Normal-000001 { margin-left: 0.70in; text-indent: -0.45in; 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.s2076340000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2076340SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2076340SCL-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2076340Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-29E-9"><span class="s2076340SENU">58-29E-9</span></a><span xml:space="preserve" class="s2076340SENU">. </span><span class="s2076340CL">Rules--Content.</span></p><p dir="ltr" class="s2076340Normal-000000"><span xml:space="preserve" class="s2076340DefaultParagraphFont">The Division of Insurance shall promulgate rules, pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-26"><span class="s2076340DefaultParagraphFont">1-26</span></a><span xml:space="preserve" class="s2076340DefaultParagraphFont">, to carry out the issuance of the license required by § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-29E-2"><span class="s2076340DefaultParagraphFont">58-29E-2</span></a><span xml:space="preserve" class="s2076340DefaultParagraphFont"> and the enforcement provisions of this chapter. The rules may include the following:</span></p><p dir="ltr" class="s2076340Normal-000001"><span class="s2076340DefaultParagraphFont">(1)    Definition of terms;</span></p><p dir="ltr" class="s2076340Normal-000001"><span class="s2076340DefaultParagraphFont">(2)    Use of prescribed forms;</span></p><p dir="ltr" class="s2076340Normal-000001"><span class="s2076340DefaultParagraphFont">(3)    Reporting requirements;</span></p><p dir="ltr" class="s2076340Normal-000001"><span class="s2076340DefaultParagraphFont">(4)    Enforcement procedures; and</span></p><p dir="ltr" class="s2076340Normal-000001"><span class="s2076340DefaultParagraphFont">(5)    Protection of proprietary information and trade secrets.</span></p><p dir="ltr" class="s2076340Normal"><span xml:space="preserve" class="s2076340000002"> </span></p><p dir="ltr" class="s2076340Normal"><span class="s2076340SCL">Source:</span><span xml:space="preserve" class="s2076340SCL-000003"> SL 2004, ch 311, § 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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s1915b08ebc4c4ee8aa634924d4158f43Normal { 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.s1915b08ebc4c4ee8aa634924d4158f43SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s1915b08ebc4c4ee8aa634924d4158f43CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s1915b08ebc4c4ee8aa634924d4158f43Statute { 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.s1915b08ebc4c4ee8aa634924d4158f43DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s1915b08ebc4c4ee8aa634924d4158f43000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s1915b08ebc4c4ee8aa634924d4158f43NoIndent { 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.s1915b08ebc4c4ee8aa634924d4158f43DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s1915b08ebc4c4ee8aa634924d4158f43SCL { 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 58-29E-10 - Enforcement of chapter--Civil action."><meta property="og:description" content="SDLRC Codified Law 58-29E-10 - Enforcement of chapter--Civil action."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes/58-29E-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="s1915b08ebc4c4ee8aa634924d4158f43Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-10" rel="noopener"><span class="s1915b08ebc4c4ee8aa634924d4158f43SENU">58-29E-10</span></a><span xml:space="preserve" class="s1915b08ebc4c4ee8aa634924d4158f43SENU">. </span><span class="s1915b08ebc4c4ee8aa634924d4158f43CL">Enforcement of chapter--Civil action.</span></p><p dir="ltr" class="s1915b08ebc4c4ee8aa634924d4158f43Statute"><span class="s1915b08ebc4c4ee8aa634924d4158f43DefaultParagraphFont">A third-party payor, 340B entity, or a pharmacy, may bring a civil action to enforce this chapter, including injunctive relief, and seek civil damages for a violation of this chapter.</span></p><p dir="ltr" class="s1915b08ebc4c4ee8aa634924d4158f43Normal"><span xml:space="preserve" class="s1915b08ebc4c4ee8aa634924d4158f43000000"> </span></p><p dir="ltr" class="s1915b08ebc4c4ee8aa634924d4158f43NoIndent"><span xml:space="preserve" class="s1915b08ebc4c4ee8aa634924d4158f43DefaultParagraphFont-000001">Source: </span><span class="s1915b08ebc4c4ee8aa634924d4158f43SCL">SL 2004, ch 311, § 10; SL 2023, ch 166, § 11; SL 2024, ch 203, § 3, eff. Jan. 1, 2025.</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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s43e2e3601e71450390a3a428188de75fNormal { 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.s43e2e3601e71450390a3a428188de75fSENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s43e2e3601e71450390a3a428188de75fDefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s43e2e3601e71450390a3a428188de75f000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s43e2e3601e71450390a3a428188de75fDefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s43e2e3601e71450390a3a428188de75fSCL { 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 58-29E-11 - Repealed."><meta property="og:description" content="SDLRC Codified Law 58-29E-11 - Repealed."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-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="s43e2e3601e71450390a3a428188de75fNormal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-11" rel="noopener"><span class="s43e2e3601e71450390a3a428188de75fSENU">58-29E-11</span></a><span xml:space="preserve" class="s43e2e3601e71450390a3a428188de75fSENU">. </span><span class="s43e2e3601e71450390a3a428188de75fDefaultParagraphFont">Repealed.</span></p><p dir="ltr" class="s43e2e3601e71450390a3a428188de75fNormal"><span xml:space="preserve" class="s43e2e3601e71450390a3a428188de75f000000"> </span></p><p dir="ltr" class="s43e2e3601e71450390a3a428188de75fNormal"><span xml:space="preserve" class="s43e2e3601e71450390a3a428188de75fDefaultParagraphFont-000001">Source: </span><span class="s43e2e3601e71450390a3a428188de75fSCL">SL 2004, ch 311, § 11; SL 2023, ch 166, § 20.</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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.sdf5324b395b0415b96a14ad4e1860274Normal { 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.sdf5324b395b0415b96a14ad4e1860274SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sdf5324b395b0415b96a14ad4e1860274CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.sdf5324b395b0415b96a14ad4e1860274Statute { 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.sdf5324b395b0415b96a14ad4e1860274DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.sdf5324b395b0415b96a14ad4e1860274000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.sdf5324b395b0415b96a14ad4e1860274NoIndent { 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.sdf5324b395b0415b96a14ad4e1860274DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sdf5324b395b0415b96a14ad4e1860274SCL { 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 58-29E-12 - Charging cost share that exceeds amount retained by pharmacy--Prohibition."><meta property="og:description" content="SDLRC Codified Law 58-29E-12 - Charging cost share that exceeds amount retained by pharmacy--Prohibition."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-12"><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="sdf5324b395b0415b96a14ad4e1860274Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-12" rel="noopener"><span class="sdf5324b395b0415b96a14ad4e1860274SENU">58-29E-12</span></a><span xml:space="preserve" class="sdf5324b395b0415b96a14ad4e1860274SENU">. </span><span class="sdf5324b395b0415b96a14ad4e1860274CL">Charging cost share that exceeds amount retained by pharmacy--Prohibition.</span></p><p dir="ltr" class="sdf5324b395b0415b96a14ad4e1860274Statute"><span class="sdf5324b395b0415b96a14ad4e1860274DefaultParagraphFont">A pharmacy benefit manager may not contractually require a pharmacy that is a participating provider in a health benefit plan provided by a third-party payor, from charging a covered individual or collecting from a covered individual a cost share for a prescription drug or pharmacy service that exceeds the amount retained by the pharmacist or pharmacy from all payment sources, for filling the prescription or providing the pharmacy service.</span></p><p dir="ltr" class="sdf5324b395b0415b96a14ad4e1860274Normal"><span xml:space="preserve" class="sdf5324b395b0415b96a14ad4e1860274000000"> </span></p><p dir="ltr" class="sdf5324b395b0415b96a14ad4e1860274NoIndent"><span xml:space="preserve" class="sdf5324b395b0415b96a14ad4e1860274DefaultParagraphFont-000001">Source: </span><span class="sdf5324b395b0415b96a14ad4e1860274SCL">SL 2019, ch 213, § 1; SL 2023, ch 166, § 12.</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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s9db2535d911e483f9b3e52ec689663fcNormal { 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.s9db2535d911e483f9b3e52ec689663fcSENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s9db2535d911e483f9b3e52ec689663fcCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s9db2535d911e483f9b3e52ec689663fcStatute { 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.s9db2535d911e483f9b3e52ec689663fcDefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s9db2535d911e483f9b3e52ec689663fcStatuteNumber1 { 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.s9db2535d911e483f9b3e52ec689663fc000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s9db2535d911e483f9b3e52ec689663fcNoIndent { 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.s9db2535d911e483f9b3e52ec689663fcDefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s9db2535d911e483f9b3e52ec689663fcSCL { 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 58-29E-13 - Certain claims adjustments prohibited."><meta property="og:description" content="SDLRC Codified Law 58-29E-13 - Certain claims adjustments prohibited."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-13"><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="s9db2535d911e483f9b3e52ec689663fcNormal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-13" rel="noopener"><span class="s9db2535d911e483f9b3e52ec689663fcSENU">58-29E-13</span></a><span xml:space="preserve" class="s9db2535d911e483f9b3e52ec689663fcSENU">. </span><span class="s9db2535d911e483f9b3e52ec689663fcCL">Certain claims adjustments prohibited.</span></p><p dir="ltr" class="s9db2535d911e483f9b3e52ec689663fcStatute"><span class="s9db2535d911e483f9b3e52ec689663fcDefaultParagraphFont">A pharmacy benefit manager may not, directly or indirectly, retroactively adjust a claim for reimbursement submitted by a pharmacy for a prescription drug, unless:</span></p><p dir="ltr" class="s9db2535d911e483f9b3e52ec689663fcStatuteNumber1"><span xml:space="preserve" class="s9db2535d911e483f9b3e52ec689663fcDefaultParagraphFont">(1)    The adjustment is necessitated by a pharmacy audit conducted in accordance with chapter </span><a href="https://sdlegislature.gov/Statutes?Statute=58-29F" rel="noopener"><span class="s9db2535d911e483f9b3e52ec689663fcDefaultParagraphFont">58-29F</span></a><span class="s9db2535d911e483f9b3e52ec689663fcDefaultParagraphFont">;</span></p><p dir="ltr" class="s9db2535d911e483f9b3e52ec689663fcStatuteNumber1"><span class="s9db2535d911e483f9b3e52ec689663fcDefaultParagraphFont">(2)    The adjustment is necessitated by a technical billing error;</span></p><p dir="ltr" class="s9db2535d911e483f9b3e52ec689663fcStatuteNumber1"><span class="s9db2535d911e483f9b3e52ec689663fcDefaultParagraphFont">(3)    The original claim was found to have been fraudulently submitted; or</span></p><p dir="ltr" class="s9db2535d911e483f9b3e52ec689663fcStatuteNumber1"><span class="s9db2535d911e483f9b3e52ec689663fcDefaultParagraphFont">(4)    The claim submission was a duplicate for which the pharmacy had already received payment.</span></p><p dir="ltr" class="s9db2535d911e483f9b3e52ec689663fcNormal"><span xml:space="preserve" class="s9db2535d911e483f9b3e52ec689663fc000000"> </span></p><p dir="ltr" class="s9db2535d911e483f9b3e52ec689663fcNoIndent"><span xml:space="preserve" class="s9db2535d911e483f9b3e52ec689663fcDefaultParagraphFont-000001">Source: </span><span class="s9db2535d911e483f9b3e52ec689663fcSCL">SL 2019, ch 213, § 2; SL 2023, ch 166, § 13.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2076345Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2076345SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2076345CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2076345Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2076345DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2076345000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2076345SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2076345SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2076345Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-29E-14"><span class="s2076345SENU">58-29E-14</span></a><span xml:space="preserve" class="s2076345SENU">. </span><span class="s2076345CL">Adjustment of claim due to error in adjudication permitted.</span></p><p dir="ltr" class="s2076345Normal-000000"><span xml:space="preserve" class="s2076345DefaultParagraphFont">Nothing in §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-29E-12"><span class="s2076345DefaultParagraphFont">58-29E-12</span></a><span xml:space="preserve" class="s2076345DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-29E-15"><span class="s2076345DefaultParagraphFont">58-29E-15</span></a><span class="s2076345DefaultParagraphFont">, inclusive, shall prohibit a pharmacy benefit manager from adjusting claim payment for the benefit of a covered individual if there was an error in the adjudication of a claim submitted by or on behalf of the covered individual.</span></p><p dir="ltr" class="s2076345Normal"><span xml:space="preserve" class="s2076345000001"> </span></p><p dir="ltr" class="s2076345Normal"><span class="s2076345SCL">Source:</span><span xml:space="preserve" class="s2076345SCL-000002"> SL 2019, 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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.se640959687774a88bb2e300bb0cd440cNormal { 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.se640959687774a88bb2e300bb0cd440cSENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.se640959687774a88bb2e300bb0cd440cCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.se640959687774a88bb2e300bb0cd440cStatute { 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.se640959687774a88bb2e300bb0cd440cDefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.se640959687774a88bb2e300bb0cd440cStatuteNumber1 { 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.se640959687774a88bb2e300bb0cd440cStatuteNumber2 { 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.se640959687774a88bb2e300bb0cd440c000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.se640959687774a88bb2e300bb0cd440cNoIndent { 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.se640959687774a88bb2e300bb0cd440cDefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.se640959687774a88bb2e300bb0cd440cSCL { 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 58-29E-15 - Discrimination prohibited--340B entity--Exclusions."><meta property="og:description" content="SDLRC Codified Law 58-29E-15 - Discrimination prohibited--340B entity--Exclusions."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes/58-29E-15"><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="se640959687774a88bb2e300bb0cd440cNormal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-15" rel="noopener"><span class="se640959687774a88bb2e300bb0cd440cSENU">58-29E-15</span></a><span xml:space="preserve" class="se640959687774a88bb2e300bb0cd440cSENU">. </span><span class="se640959687774a88bb2e300bb0cd440cCL">Discrimination prohibited--340B entity--Exclusions.</span></p><p dir="ltr" class="se640959687774a88bb2e300bb0cd440cStatute"><span class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont">Neither a pharmacy benefit manager nor a pharmacy benefit manager affiliate may, directly or indirectly, discriminate against a 340B entity or a pharmacy under contract with a 340B entity, on the basis that the 340B entity or a pharmacy under contract with a 340B entity participates in the 340B drug discount program by imposing terms or conditions that differ from a similarly situated entity that does not participate in the 340B drug discount program.</span></p><p dir="ltr" class="se640959687774a88bb2e300bb0cd440cStatute"><span class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont">Discriminatory acts include:</span></p><p dir="ltr" class="se640959687774a88bb2e300bb0cd440cStatuteNumber1"><span class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont">(1)    Reimbursing a 340B entity at a rate lower than that paid for the same drug to a pharmacy that has a similar prescription volume but is not a 340B entity;</span></p><p dir="ltr" class="se640959687774a88bb2e300bb0cd440cStatuteNumber1"><span class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont">(2)    Assessing a fee or cost, imposing a charge back, or imposing any other adjustment against a 340B entity, on the ground that the 340B entity participates in the 340B drug discount program;</span></p><p dir="ltr" class="se640959687774a88bb2e300bb0cd440cStatuteNumber1"><span class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont">(3)    Restricting access by a 340B entity to a pharmacy network on the ground that the 340B entity participates in the 340B drug discount program;</span></p><p dir="ltr" class="se640959687774a88bb2e300bb0cd440cStatuteNumber1"><span class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont">(4)    Requiring that a 340B entity contract with a specific pharmacy or health coverage plan as a condition of participating in a pharmacy network;</span></p><p dir="ltr" class="se640959687774a88bb2e300bb0cd440cStatuteNumber1"><span class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont">(5)    Imposing a new restriction or an additional charge on a patient who elects to receive a prescription drug through a 340B entity;</span></p><p dir="ltr" class="se640959687774a88bb2e300bb0cd440cStatuteNumber1"><span class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont">(6)    Restricting the method by which a 340B entity may dispense or deliver 340B drugs;</span></p><p dir="ltr" class="se640959687774a88bb2e300bb0cd440cStatuteNumber1"><span xml:space="preserve" class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont">(7)    Auditing a 340B entity, as provided for under § </span><a href="https://sdlegislature.gov/Statutes?Statute=58-29F-1" rel="noopener"><span class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont">58-29F-1</span></a><span class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont">, more frequently than similarly situated entities that do not participate in the 340B drug discount program;</span></p><p dir="ltr" class="se640959687774a88bb2e300bb0cd440cStatuteNumber1"><span class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont">(8)    Refusing to provide reimbursement or coverage for 340B drugs that are part of a formulary;</span></p><p dir="ltr" class="se640959687774a88bb2e300bb0cd440cStatuteNumber1"><span class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont">(9)    Basing prescription drug benefit coverage or formulary decisions on:</span></p><p dir="ltr" class="se640959687774a88bb2e300bb0cd440cStatuteNumber2"><span class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont">(a)    The 340B status of a drug, including price or availability; or</span></p><p dir="ltr" class="se640959687774a88bb2e300bb0cd440cStatuteNumber2"><span class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont">(b)    Whether a dispensing pharmacy participates in 340B drug pricing;</span></p><p dir="ltr" class="se640959687774a88bb2e300bb0cd440cStatuteNumber1"><span class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont">(10)    Imposing on a 340B entity any requirement or restriction that interferes with the entity s ability to maximize the value of the discounts obtained through participation in the 340B drug discount program; and</span></p><p dir="ltr" class="se640959687774a88bb2e300bb0cd440cStatuteNumber1"><span class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont">(11)    Imposing on a 340B entity any contractual terms and conditions that differ from those imposed on a similarly situated entity that is not a 340B entity.</span></p><p dir="ltr" class="se640959687774a88bb2e300bb0cd440cNormal"><span xml:space="preserve" class="se640959687774a88bb2e300bb0cd440c000000"> </span></p><p dir="ltr" class="se640959687774a88bb2e300bb0cd440cNoIndent"><span xml:space="preserve" class="se640959687774a88bb2e300bb0cd440cDefaultParagraphFont-000001">Source: </span><span class="se640959687774a88bb2e300bb0cd440cSCL">SL 2019, ch 213, § 4; SL 2024, ch 203, § 4, eff. Jan. 1, 2025.</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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s13b4f3f464ca435d85b3601af7e88a67Normal { 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.s13b4f3f464ca435d85b3601af7e88a67SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s13b4f3f464ca435d85b3601af7e88a67CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s13b4f3f464ca435d85b3601af7e88a67Statute { 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.s13b4f3f464ca435d85b3601af7e88a67DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s13b4f3f464ca435d85b3601af7e88a67000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s13b4f3f464ca435d85b3601af7e88a67NoIndent { 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.s13b4f3f464ca435d85b3601af7e88a67DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s13b4f3f464ca435d85b3601af7e88a67SCL { 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 58-29E-15.1 - Discrimination prohibited--Treble damages."><meta property="og:description" content="SDLRC Codified Law 58-29E-15.1 - Discrimination prohibited--Treble damages."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes/58-29E-15.1"><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="s13b4f3f464ca435d85b3601af7e88a67Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-15.1" rel="noopener"><span class="s13b4f3f464ca435d85b3601af7e88a67SENU">58-29E-15.1</span></a><span xml:space="preserve" class="s13b4f3f464ca435d85b3601af7e88a67SENU">. </span><span class="s13b4f3f464ca435d85b3601af7e88a67CL">Discrimination prohibited--Treble damages.</span></p><p dir="ltr" class="s13b4f3f464ca435d85b3601af7e88a67Statute"><span xml:space="preserve" class="s13b4f3f464ca435d85b3601af7e88a67DefaultParagraphFont">A pharmacy benefit manager or a pharmacy benefit manager affiliate who has engaged in a discriminatory act, as prohibited in § </span><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-15" rel="noopener"><span class="s13b4f3f464ca435d85b3601af7e88a67DefaultParagraphFont">58-29E-15</span></a><span class="s13b4f3f464ca435d85b3601af7e88a67DefaultParagraphFont">, is liable to the 340B entity for damages, including actual and consequential damages, and is liable for reasonable attorneys' fees and costs.</span></p><p dir="ltr" class="s13b4f3f464ca435d85b3601af7e88a67Normal"><span xml:space="preserve" class="s13b4f3f464ca435d85b3601af7e88a67000000"> </span></p><p dir="ltr" class="s13b4f3f464ca435d85b3601af7e88a67NoIndent"><span xml:space="preserve" class="s13b4f3f464ca435d85b3601af7e88a67DefaultParagraphFont-000001">Source: </span><span class="s13b4f3f464ca435d85b3601af7e88a67SCL">SL 2024, ch 203, § 5, eff. Jan. 1, 2025.</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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s997566668a0242eb8b63abb6368cfce2Normal { 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.s997566668a0242eb8b63abb6368cfce2SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s997566668a0242eb8b63abb6368cfce2CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s997566668a0242eb8b63abb6368cfce2Statute { 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.s997566668a0242eb8b63abb6368cfce2DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s997566668a0242eb8b63abb6368cfce2StatuteNumber1 { 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.s997566668a0242eb8b63abb6368cfce2000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s997566668a0242eb8b63abb6368cfce2NoIndent { 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.s997566668a0242eb8b63abb6368cfce2DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s997566668a0242eb8b63abb6368cfce2SCL { 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 58-29E-16 - Prohibition regarding the assessment or collection of fees."><meta property="og:description" content="SDLRC Codified Law 58-29E-16 - Prohibition regarding the assessment or collection of fees."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-16"><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="s997566668a0242eb8b63abb6368cfce2Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-16" rel="noopener"><span class="s997566668a0242eb8b63abb6368cfce2SENU">58-29E-16</span></a><span xml:space="preserve" class="s997566668a0242eb8b63abb6368cfce2SENU">. </span><span class="s997566668a0242eb8b63abb6368cfce2CL">Prohibition regarding the assessment or collection of fees.</span></p><p dir="ltr" class="s997566668a0242eb8b63abb6368cfce2Statute"><span class="s997566668a0242eb8b63abb6368cfce2DefaultParagraphFont">A pharmacy benefit manager may not assess, charge, or collect, from a pharmacy or pharmacist, any remuneration or fee, including:</span></p><p dir="ltr" class="s997566668a0242eb8b63abb6368cfce2StatuteNumber1"><span class="s997566668a0242eb8b63abb6368cfce2DefaultParagraphFont">(1)    An accreditation fee;</span></p><p dir="ltr" class="s997566668a0242eb8b63abb6368cfce2StatuteNumber1"><span class="s997566668a0242eb8b63abb6368cfce2DefaultParagraphFont">(2)    A brand effective rate fee;</span></p><p dir="ltr" class="s997566668a0242eb8b63abb6368cfce2StatuteNumber1"><span class="s997566668a0242eb8b63abb6368cfce2DefaultParagraphFont">(3)    A claim processing fee;</span></p><p dir="ltr" class="s997566668a0242eb8b63abb6368cfce2StatuteNumber1"><span class="s997566668a0242eb8b63abb6368cfce2DefaultParagraphFont">(4)    A credentialing fee;</span></p><p dir="ltr" class="s997566668a0242eb8b63abb6368cfce2StatuteNumber1"><span class="s997566668a0242eb8b63abb6368cfce2DefaultParagraphFont">(5)    A dispensing fee;</span></p><p dir="ltr" class="s997566668a0242eb8b63abb6368cfce2StatuteNumber1"><span class="s997566668a0242eb8b63abb6368cfce2DefaultParagraphFont">(6)    An effective rate fee;</span></p><p dir="ltr" class="s997566668a0242eb8b63abb6368cfce2StatuteNumber1"><span class="s997566668a0242eb8b63abb6368cfce2DefaultParagraphFont">(7)    A generic effective rate fee;</span></p><p dir="ltr" class="s997566668a0242eb8b63abb6368cfce2StatuteNumber1"><span class="s997566668a0242eb8b63abb6368cfce2DefaultParagraphFont">(8)    A pharmacy network participation fee; and</span></p><p dir="ltr" class="s997566668a0242eb8b63abb6368cfce2StatuteNumber1"><span class="s997566668a0242eb8b63abb6368cfce2DefaultParagraphFont">(9)    A performance-based fee.</span></p><p dir="ltr" class="s997566668a0242eb8b63abb6368cfce2Normal"><span xml:space="preserve" class="s997566668a0242eb8b63abb6368cfce2000000"> </span></p><p dir="ltr" class="s997566668a0242eb8b63abb6368cfce2NoIndent"><span xml:space="preserve" class="s997566668a0242eb8b63abb6368cfce2DefaultParagraphFont-000001">Source: </span><span class="s997566668a0242eb8b63abb6368cfce2SCL">SL 2023, ch 166, § 14.</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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s19dbaab23fa94fa5873dd01665a92860Normal { 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.s19dbaab23fa94fa5873dd01665a92860SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s19dbaab23fa94fa5873dd01665a92860CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s19dbaab23fa94fa5873dd01665a92860Statute { 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.s19dbaab23fa94fa5873dd01665a92860DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s19dbaab23fa94fa5873dd01665a92860StatuteNumber1 { 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.s19dbaab23fa94fa5873dd01665a92860000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s19dbaab23fa94fa5873dd01665a92860NoIndent { 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.s19dbaab23fa94fa5873dd01665a92860DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s19dbaab23fa94fa5873dd01665a92860SCL { 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 58-29E-17 - Placement on a maximum allowable cost list--Requirements--Promulgation of rules."><meta property="og:description" content="SDLRC Codified Law 58-29E-17 - Placement on a maximum allowable cost list--Requirements--Promulgation of rules."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-17"><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="s19dbaab23fa94fa5873dd01665a92860Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-17" rel="noopener"><span class="s19dbaab23fa94fa5873dd01665a92860SENU">58-29E-17</span></a><span xml:space="preserve" class="s19dbaab23fa94fa5873dd01665a92860SENU">. </span><span class="s19dbaab23fa94fa5873dd01665a92860CL">Placement on a maximum allowable cost list--Requirements--Promulgation of rules.</span></p><p dir="ltr" class="s19dbaab23fa94fa5873dd01665a92860Statute"><span class="s19dbaab23fa94fa5873dd01665a92860DefaultParagraphFont">Prior to placing a prescription drug on a maximum allowable cost list, a pharmacy benefit manager shall ensure that the prescription drug is:</span></p><p dir="ltr" class="s19dbaab23fa94fa5873dd01665a92860StatuteNumber1"><span xml:space="preserve" class="s19dbaab23fa94fa5873dd01665a92860DefaultParagraphFont">(1)    Listed as therapeutically and pharmaceutically equivalent in the latest edition of, or any supplement to, the Food and Drug Administration's publication entitled Approved Drug Products with Therapeutic Equivalence Evaluations, as adopted by the State Board of Pharmacy, in rules promulgated pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes?Statute=1-26" rel="noopener"><span class="s19dbaab23fa94fa5873dd01665a92860DefaultParagraphFont">1-26</span></a><span class="s19dbaab23fa94fa5873dd01665a92860DefaultParagraphFont">;</span></p><p dir="ltr" class="s19dbaab23fa94fa5873dd01665a92860StatuteNumber1"><span class="s19dbaab23fa94fa5873dd01665a92860DefaultParagraphFont">(2)    Not obsolete or temporarily unavailable; and</span></p><p dir="ltr" class="s19dbaab23fa94fa5873dd01665a92860StatuteNumber1"><span class="s19dbaab23fa94fa5873dd01665a92860DefaultParagraphFont">(3)    Available for purchase, without limitation, by every pharmacy in this state, from a national or regional wholesale distributor licensed in this state.</span></p><p dir="ltr" class="s19dbaab23fa94fa5873dd01665a92860Normal"><span xml:space="preserve" class="s19dbaab23fa94fa5873dd01665a92860000000"> </span></p><p dir="ltr" class="s19dbaab23fa94fa5873dd01665a92860NoIndent"><span xml:space="preserve" class="s19dbaab23fa94fa5873dd01665a92860DefaultParagraphFont-000001">Source: </span><span class="s19dbaab23fa94fa5873dd01665a92860SCL">SL 2023, ch 166, § 15.</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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s17d9bd3ccc444ce183c9601d5530ff43Normal { 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.s17d9bd3ccc444ce183c9601d5530ff43SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s17d9bd3ccc444ce183c9601d5530ff43CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s17d9bd3ccc444ce183c9601d5530ff43Statute { 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.s17d9bd3ccc444ce183c9601d5530ff43DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s17d9bd3ccc444ce183c9601d5530ff43StatuteNumber1 { 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.s17d9bd3ccc444ce183c9601d5530ff43000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s17d9bd3ccc444ce183c9601d5530ff43NoIndent { 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.s17d9bd3ccc444ce183c9601d5530ff43DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s17d9bd3ccc444ce183c9601d5530ff43SCL { 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 58-29E-18 - Duties--Pharmacy benefit manager."><meta property="og:description" content="SDLRC Codified Law 58-29E-18 - Duties--Pharmacy benefit manager."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-18"><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="s17d9bd3ccc444ce183c9601d5530ff43Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-18" rel="noopener"><span class="s17d9bd3ccc444ce183c9601d5530ff43SENU">58-29E-18</span></a><span xml:space="preserve" class="s17d9bd3ccc444ce183c9601d5530ff43SENU">. </span><span class="s17d9bd3ccc444ce183c9601d5530ff43CL">Duties--Pharmacy benefit manager.</span></p><p dir="ltr" class="s17d9bd3ccc444ce183c9601d5530ff43Statute"><span class="s17d9bd3ccc444ce183c9601d5530ff43DefaultParagraphFont">A pharmacy benefit manager shall:</span></p><p dir="ltr" class="s17d9bd3ccc444ce183c9601d5530ff43StatuteNumber1"><span class="s17d9bd3ccc444ce183c9601d5530ff43DefaultParagraphFont">(1)    Provide each pharmacy in a pharmacy network with reasonable access to each maximum allowable cost list to which the pharmacy is subject;</span></p><p dir="ltr" class="s17d9bd3ccc444ce183c9601d5530ff43StatuteNumber1"><span class="s17d9bd3ccc444ce183c9601d5530ff43DefaultParagraphFont">(2)    Update a maximum allowable cost list, within seven calendar days from the date of any increase, at or above ten percent, in the price charged for a prescription drug on the list by one or more wholesale distributors doing business in this state;</span></p><p dir="ltr" class="s17d9bd3ccc444ce183c9601d5530ff43StatuteNumber1"><span class="s17d9bd3ccc444ce183c9601d5530ff43DefaultParagraphFont">(3)    Update the maximum allowable cost list, within seven calendar days from the date of any change in the methodology, or any change in the value of a variable applied in the methodology, on which the maximum allowable cost list is based; and</span></p><p dir="ltr" class="s17d9bd3ccc444ce183c9601d5530ff43StatuteNumber1"><span class="s17d9bd3ccc444ce183c9601d5530ff43DefaultParagraphFont">(4)    Provide a process under which each pharmacy in a pharmacy network may receive prompt notice of any change in a maximum allowable cost list to which the pharmacy is subject.</span></p><p dir="ltr" class="s17d9bd3ccc444ce183c9601d5530ff43Normal"><span xml:space="preserve" class="s17d9bd3ccc444ce183c9601d5530ff43000000"> </span></p><p dir="ltr" class="s17d9bd3ccc444ce183c9601d5530ff43NoIndent"><span xml:space="preserve" class="s17d9bd3ccc444ce183c9601d5530ff43DefaultParagraphFont-000001">Source: </span><span class="s17d9bd3ccc444ce183c9601d5530ff43SCL">SL 2023, ch 166, § 16.</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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.sb3882d94de414ff883ece85844eb111dNormal { 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.sb3882d94de414ff883ece85844eb111dSENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sb3882d94de414ff883ece85844eb111dCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.sb3882d94de414ff883ece85844eb111dStatute { 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.sb3882d94de414ff883ece85844eb111dDefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.sb3882d94de414ff883ece85844eb111d000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.sb3882d94de414ff883ece85844eb111dNoIndent { 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.sb3882d94de414ff883ece85844eb111dDefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sb3882d94de414ff883ece85844eb111dSCL { 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 58-29E-19 - Reimbursement."><meta property="og:description" content="SDLRC Codified Law 58-29E-19 - Reimbursement."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-19"><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="sb3882d94de414ff883ece85844eb111dNormal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-19" rel="noopener"><span class="sb3882d94de414ff883ece85844eb111dSENU">58-29E-19</span></a><span xml:space="preserve" class="sb3882d94de414ff883ece85844eb111dSENU">. </span><span class="sb3882d94de414ff883ece85844eb111dCL">Reimbursement.</span></p><p dir="ltr" class="sb3882d94de414ff883ece85844eb111dStatute"><span class="sb3882d94de414ff883ece85844eb111dDefaultParagraphFont">A pharmacy benefit manager may not reimburse any pharmacy located in this state an amount that is less than that which the pharmacy benefit manager reimburses a pharmacy benefit manager affiliate for dispensing the same prescription drug as that dispensed by the pharmacy.</span></p><p dir="ltr" class="sb3882d94de414ff883ece85844eb111dStatute"><span class="sb3882d94de414ff883ece85844eb111dDefaultParagraphFont">The reimbursement amount must be calculated on a per unit basis, using the same generic product identifier or generic code number.</span></p><p dir="ltr" class="sb3882d94de414ff883ece85844eb111dNormal"><span xml:space="preserve" class="sb3882d94de414ff883ece85844eb111d000000"> </span></p><p dir="ltr" class="sb3882d94de414ff883ece85844eb111dNoIndent"><span xml:space="preserve" class="sb3882d94de414ff883ece85844eb111dDefaultParagraphFont-000001">Source: </span><span class="sb3882d94de414ff883ece85844eb111dSCL">SL 2023, ch 166, § 17.</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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.sf24e6618fa5f4f109a6ae0808504e8b7Normal { 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.sf24e6618fa5f4f109a6ae0808504e8b7SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sf24e6618fa5f4f109a6ae0808504e8b7CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.sf24e6618fa5f4f109a6ae0808504e8b7Statute { text-indent: 0.25in; 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.sf24e6618fa5f4f109a6ae0808504e8b7DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.sf24e6618fa5f4f109a6ae0808504e8b7StatuteNumber1 { 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.sf24e6618fa5f4f109a6ae0808504e8b7000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.sf24e6618fa5f4f109a6ae0808504e8b7NoIndent { 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.sf24e6618fa5f4f109a6ae0808504e8b7DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sf24e6618fa5f4f109a6ae0808504e8b7SCL { 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 58-29E-20 - Information to be disclosed--Division request."><meta property="og:description" content="SDLRC Codified Law 58-29E-20 - Information to be disclosed--Division request."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-20"><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="sf24e6618fa5f4f109a6ae0808504e8b7Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-20" rel="noopener"><span class="sf24e6618fa5f4f109a6ae0808504e8b7SENU">58-29E-20</span></a><span xml:space="preserve" class="sf24e6618fa5f4f109a6ae0808504e8b7SENU">. </span><span class="sf24e6618fa5f4f109a6ae0808504e8b7CL">Information to be disclosed--Division request.</span></p><p dir="ltr" class="sf24e6618fa5f4f109a6ae0808504e8b7Statute"><span class="sf24e6618fa5f4f109a6ae0808504e8b7DefaultParagraphFont">A pharmacy benefit manager licensed under this chapter shall, at the request of the Division of Insurance, provide:</span></p><p dir="ltr" class="sf24e6618fa5f4f109a6ae0808504e8b7StatuteNumber1"><span class="sf24e6618fa5f4f109a6ae0808504e8b7DefaultParagraphFont">(1)    The amount charged or claimed by the pharmacy benefit manager, in a format that allows the division to identify all instances of spread pricing; and</span></p><p dir="ltr" class="sf24e6618fa5f4f109a6ae0808504e8b7StatuteNumber1"><span xml:space="preserve" class="sf24e6618fa5f4f109a6ae0808504e8b7DefaultParagraphFont">(2)    Information regarding a shared ownership interest by any person defined in § </span><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-1" rel="noopener"><span class="sf24e6618fa5f4f109a6ae0808504e8b7DefaultParagraphFont">58-29E-1</span></a><span class="sf24e6618fa5f4f109a6ae0808504e8b7DefaultParagraphFont">.</span></p><p dir="ltr" class="sf24e6618fa5f4f109a6ae0808504e8b7Normal"><span xml:space="preserve" class="sf24e6618fa5f4f109a6ae0808504e8b7000000"> </span></p><p dir="ltr" class="sf24e6618fa5f4f109a6ae0808504e8b7NoIndent"><span xml:space="preserve" class="sf24e6618fa5f4f109a6ae0808504e8b7DefaultParagraphFont-000001">Source: </span><span class="sf24e6618fa5f4f109a6ae0808504e8b7SCL">SL 2023, ch 166, § 18.</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 58-29E - PHARMACY BENEFITS MANAGEMENT</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.sd2afac3d0432483a93387a3f26acd71cNormal { 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.sd2afac3d0432483a93387a3f26acd71cSENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sd2afac3d0432483a93387a3f26acd71cCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.sd2afac3d0432483a93387a3f26acd71cStatute { 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.sd2afac3d0432483a93387a3f26acd71cDefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.sd2afac3d0432483a93387a3f26acd71c000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.sd2afac3d0432483a93387a3f26acd71cNoIndent { 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.sd2afac3d0432483a93387a3f26acd71cDefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sd2afac3d0432483a93387a3f26acd71cSCL { 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 58-29E-21 - Licensure--Denial--Failure to provide information."><meta property="og:description" content="SDLRC Codified Law 58-29E-21 - Licensure--Denial--Failure to provide information."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-21"><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="sd2afac3d0432483a93387a3f26acd71cNormal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-21" rel="noopener"><span class="sd2afac3d0432483a93387a3f26acd71cSENU">58-29E-21</span></a><span xml:space="preserve" class="sd2afac3d0432483a93387a3f26acd71cSENU">. </span><span class="sd2afac3d0432483a93387a3f26acd71cCL">Licensure--Denial--Failure to provide information.</span></p><p dir="ltr" class="sd2afac3d0432483a93387a3f26acd71cStatute"><span xml:space="preserve" class="sd2afac3d0432483a93387a3f26acd71cDefaultParagraphFont">In addition to any grounds set forth in § </span><a href="https://sdlegislature.gov/Statutes?Statute=58-29D-31" rel="noopener"><span class="sd2afac3d0432483a93387a3f26acd71cDefaultParagraphFont">58-29D-31</span></a><span class="sd2afac3d0432483a93387a3f26acd71cDefaultParagraphFont">, the director may deny a pharmacy benefit manager's application for an initial or a renewed license, and may suspend or revoke a pharmacy benefit manager's license, if the director determines that the pharmacy benefit manager, or an applicant for a license, failed to provide information as required by this chapter.</span></p><p dir="ltr" class="sd2afac3d0432483a93387a3f26acd71cNormal"><span xml:space="preserve" class="sd2afac3d0432483a93387a3f26acd71c000000"> </span></p><p dir="ltr" class="sd2afac3d0432483a93387a3f26acd71cNoIndent"><span xml:space="preserve" class="sd2afac3d0432483a93387a3f26acd71cDefaultParagraphFont-000001">Source: </span><span class="sd2afac3d0432483a93387a3f26acd71cSCL">SL 2023, ch 166, § 19.</span></p></div></body></html>