South Dakota 2025 Regular Session

South Dakota House Bill HB1137 Compare Versions

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11 25.694.9 100th Legislative Session 1137
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44 2025 South Dakota Legislature
55 House Bill 1137
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1212 Introduced by: Representative Mulder
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1414 Underscores indicate new language.
1515 Overstrikes indicate deleted language.
1616 An Act to establish provisions related to the treatment of pain with non -opioid 1
1717 drugs. 2
1818 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF SOUTH DAKOTA: 3
1919 Section 1. That a NEW SECTION be added to chapter 28-6: 4
2020 The Department of Social Services shall establish a preferred drug list for the 5
2121 medical assistance program. The department may amend the preferred drug list at any 6
2222 time. 7
2323 When establishing or amending the preferred drug list, the department shall ensure 8
2424 that a non-opioid drug approved by the United States Food and Drug Administration for 9
2525 the treatment or management of pain is not disadvantaged or discouraged with respect 10
2626 to coverage relative to any opioid or narcotic drug for the treatment or management of 11
2727 pain on the preferred drug list. 12
2828 This section applies to a non-opioid drug immediately upon its approval by the 13
2929 United States Food and Drug Administration for the treatment or management of pain, 14
3030 regardless of whether the drug has been reviewed by the department for inclusion on the 15
3131 preferred drug list. 16
3232 Section 2. That a NEW SECTION be added to chapter 58-17: 17
3333 In establishing and maintaining its formulary, any insurer offering a policy or 18
3434 certificate of health insurance that is delivered, issued for delivery, or renewed in this 19
3535 state, or any self-funded employee benefit plan, to the extent not preempted by federal 20
3636 law, must ensure that a non-opioid drug approved by the United States Food and Drug 21
3737 Administration for the treatment or management of pain is not disadvantaged or 22
3838 discouraged with respect to coverage relative to any opioid or narcotic drug for the 23
3939 treatment or management of pain on the formulary. 24 25.694.9 2 1137
4040 Underscores indicate new language.
4141 Overstrikes indicate deleted language.
4242 This section applies to a non-opioid drug immediately upon its approval by the 1
4343 United States Food and Drug Administration for the treatment or management of pain, 2
4444 regardless of whether the drug has been reviewed for inclusion on the formulary. 3
4545 Section 3. That a NEW SECTION be added to chapter 58-17: 4
4646 When a health care professional prescribes a non-opioid drug for the treatment of 5
4747 or management of pain, a health insurer, or a self-funded employee benefit plan, to the 6
4848 extent not preempted by federal law, may not deny coverage of the non -opioid drug in 7
4949 favor of an opioid drug. 8
5050 If a policy or certificate of health insurance delivered, issued for delivery, or 9
5151 renewed in this state, or a self-funded employee benefit plan, to the extent not preempted 10
5252 by federal law, restricts coverage of a non-opioid drug for the treatment or management 11
5353 of pain, the prescribing health care professional must be granted an exception to the 12
5454 restriction, if the professional confirms that, based on the professional's clinical judgment, 13
5555 the non-opioid drug is appropriate for the patient's treatment. 14