1 | 1 | | 25.694.9 100th Legislative Session 1137 |
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4 | 4 | | 2025 South Dakota Legislature |
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5 | 5 | | House Bill 1137 |
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12 | 12 | | Introduced by: Representative Mulder |
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14 | 14 | | Underscores indicate new language. |
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15 | 15 | | Overstrikes indicate deleted language. |
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16 | 16 | | An Act to establish provisions related to the treatment of pain with non -opioid 1 |
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17 | 17 | | drugs. 2 |
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18 | 18 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF SOUTH DAKOTA: 3 |
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19 | 19 | | Section 1. That a NEW SECTION be added to chapter 28-6: 4 |
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20 | 20 | | The Department of Social Services shall establish a preferred drug list for the 5 |
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21 | 21 | | medical assistance program. The department may amend the preferred drug list at any 6 |
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22 | 22 | | time. 7 |
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23 | 23 | | When establishing or amending the preferred drug list, the department shall ensure 8 |
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24 | 24 | | that a non-opioid drug approved by the United States Food and Drug Administration for 9 |
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25 | 25 | | the treatment or management of pain is not disadvantaged or discouraged with respect 10 |
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26 | 26 | | to coverage relative to any opioid or narcotic drug for the treatment or management of 11 |
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27 | 27 | | pain on the preferred drug list. 12 |
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28 | 28 | | This section applies to a non-opioid drug immediately upon its approval by the 13 |
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29 | 29 | | United States Food and Drug Administration for the treatment or management of pain, 14 |
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30 | 30 | | regardless of whether the drug has been reviewed by the department for inclusion on the 15 |
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31 | 31 | | preferred drug list. 16 |
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32 | 32 | | Section 2. That a NEW SECTION be added to chapter 58-17: 17 |
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33 | 33 | | In establishing and maintaining its formulary, any insurer offering a policy or 18 |
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34 | 34 | | certificate of health insurance that is delivered, issued for delivery, or renewed in this 19 |
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35 | 35 | | state, or any self-funded employee benefit plan, to the extent not preempted by federal 20 |
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36 | 36 | | law, must ensure that a non-opioid drug approved by the United States Food and Drug 21 |
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37 | 37 | | Administration for the treatment or management of pain is not disadvantaged or 22 |
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38 | 38 | | discouraged with respect to coverage relative to any opioid or narcotic drug for the 23 |
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39 | 39 | | treatment or management of pain on the formulary. 24 25.694.9 2 1137 |
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40 | 40 | | Underscores indicate new language. |
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41 | 41 | | Overstrikes indicate deleted language. |
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42 | 42 | | This section applies to a non-opioid drug immediately upon its approval by the 1 |
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43 | 43 | | United States Food and Drug Administration for the treatment or management of pain, 2 |
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44 | 44 | | regardless of whether the drug has been reviewed for inclusion on the formulary. 3 |
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45 | 45 | | Section 3. That a NEW SECTION be added to chapter 58-17: 4 |
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46 | 46 | | When a health care professional prescribes a non-opioid drug for the treatment of 5 |
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47 | 47 | | or management of pain, a health insurer, or a self-funded employee benefit plan, to the 6 |
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48 | 48 | | extent not preempted by federal law, may not deny coverage of the non -opioid drug in 7 |
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49 | 49 | | favor of an opioid drug. 8 |
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50 | 50 | | If a policy or certificate of health insurance delivered, issued for delivery, or 9 |
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51 | 51 | | renewed in this state, or a self-funded employee benefit plan, to the extent not preempted 10 |
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52 | 52 | | by federal law, restricts coverage of a non-opioid drug for the treatment or management 11 |
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53 | 53 | | of pain, the prescribing health care professional must be granted an exception to the 12 |
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54 | 54 | | restriction, if the professional confirms that, based on the professional's clinical judgment, 13 |
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55 | 55 | | the non-opioid drug is appropriate for the patient's treatment. 14 |
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