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79 chapters · 3,426 sections in this title.
SDCL § 58-29E-1 Definitions
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Terms used in this chapter mean: (1) "Brand name," the same as set forth in § 36-11-2 ; (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 t…
SDCL § 58-29E-10 Enforcement of chapter--Civil action
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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. Source: SL 2004, ch 311 , § 10; SL 2023, ch 166 , § 11; SL 2024, ch 203 , § 3, eff. Jan. 1, 2025…
SDCL § 58-29E-12 Charging cost share that exceeds amount retained by pharmacy--Prohibition
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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 pharma…
SDCL § 58-29E-13 Certain claims adjustments prohibited
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A pharmacy benefit manager may not, directly or indirectly, retroactively adjust a claim for reimbursement submitted by a pharmacy for a prescription drug, unless: (1) The adjustment is necessitated by a pharmacy audit conducted in accordance with chapter 58-29F ; (2) The adjustm…
