25.694.9 100th Legislative Session 1137
2025 South Dakota Legislature
House Bill 1137
Introduced by: Representative Mulder
Underscores indicate new language.
Overstrikes indicate deleted language.
An Act to establish provisions related to the treatment of pain with non -opioid 1
drugs. 2
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF SOUTH DAKOTA: 3
Section 1. That a NEW SECTION be added to chapter 28-6: 4
The Department of Social Services shall establish a preferred drug list for the 5
medical assistance program. The department may amend the preferred drug list at any 6
time. 7
When establishing or amending the preferred drug list, the department shall ensure 8
that a non-opioid drug approved by the United States Food and Drug Administration for 9
the treatment or management of pain is not disadvantaged or discouraged with respect 10
to coverage relative to any opioid or narcotic drug for the treatment or management of 11
pain on the preferred drug list. 12
This section applies to a non-opioid drug immediately upon its approval by the 13
United States Food and Drug Administration for the treatment or management of pain, 14
regardless of whether the drug has been reviewed by the department for inclusion on the 15
preferred drug list. 16
Section 2. That a NEW SECTION be added to chapter 58-17: 17
In establishing and maintaining its formulary, any insurer offering a policy or 18
certificate of health insurance that is delivered, issued for delivery, or renewed in this 19
state, or any self-funded employee benefit plan, to the extent not preempted by federal 20
law, must ensure that a non-opioid drug approved by the United States Food and Drug 21
Administration for the treatment or management of pain is not disadvantaged or 22
discouraged with respect to coverage relative to any opioid or narcotic drug for the 23
treatment or management of pain on the formulary. 24 25.694.9 2 1137
Underscores indicate new language.
Overstrikes indicate deleted language.
This section applies to a non-opioid drug immediately upon its approval by the 1
United States Food and Drug Administration for the treatment or management of pain, 2
regardless of whether the drug has been reviewed for inclusion on the formulary. 3
Section 3. That a NEW SECTION be added to chapter 58-17: 4
When a health care professional prescribes a non-opioid drug for the treatment of 5
or management of pain, a health insurer, or a self-funded employee benefit plan, to the 6
extent not preempted by federal law, may not deny coverage of the non -opioid drug in 7
favor of an opioid drug. 8
If a policy or certificate of health insurance delivered, issued for delivery, or 9
renewed in this state, or a self-funded employee benefit plan, to the extent not preempted 10
by federal law, restricts coverage of a non-opioid drug for the treatment or management 11
of pain, the prescribing health care professional must be granted an exception to the 12
restriction, if the professional confirms that, based on the professional's clinical judgment, 13
the non-opioid drug is appropriate for the patient's treatment. 14