South Dakota2026Active

HB1199

South Dakota Law on Health Insurance Approval Rules

Last scannedAug 25, 2026, 3:29 AM

In one sentence

This law requires health insurance companies and review organizations to report how often they approve or deny medical service requests and to remove approval rules that are rarely denied.

Requires insurers to send an annual report showing the number of urgent and non-urgent prior authorization requests approved or denied.
Mandates reports on the average time it takes for insurers to make a decision on medical service requests.
Orders insurers to review all services requiring approval and remove those requirements if most requests are routinely approved without improving quality or reducing costs enough to justify administrative expenses.
Requires a second annual report listing which approvals were removed, why some high-approval rules stayed in place based on evidence, and how claim numbers changed after removals.
Directs the Division of Insurance to publish these reports on its website within 60 days of receiving them.

The law does not apply to dental services, pharmaceutical services, or prescription drug products.
The specific date the law takes effect is not listed in the provided text.
The exact format for reports is determined by the Division of Insurance.

Plain language

Prior authorization: A rule requiring a patient or doctor to get permission from an insurance company before receiving certain medical services.
Utilization review organization: An entity that reviews health care requests for insurers to decide if they are medically necessary.

Official record

Source attached

address prior authorization and reporting requirements by utilization review organizations and health carriers.

Official activity