establish provisions for the coverage of nonopioid prescription drugs.

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

establish provisions for the coverage of nonopioid prescription drugs.

establish provisions for the coverage of nonopioid prescription drugs.

What This Bill Does

• establish provisions for the coverage of nonopioid prescription drugs.
• Official keyword topics: Health Care Health Maintenance Organizations Insurance Official sponsor note: Representatives <a rel="noopener" href="https://sdlegislature.gov/Legislators/Profile/4793/Detail">Mulder</a> (prime), <a rel="noopener" href="https://sdlegislature.gov/Legislators/Profile/4749/Detail">Emery</a>, <a rel="noopener" href="https://sdlegislature.gov/Legislators/Profile/4753/Detail">Goodwin</a>, <a rel="noopener" href="https://sdlegislature.gov/Legislators/Profile/4789/Detail">Moore</a>, <a rel="noopener" href="https://sdlegislature.gov/Legislators/Profile/4791/Detail">Muckey</a>, <a rel="noopener" href="https://sdlegislature.gov/Legislators/Profile/4824/Detail">Uhre-Balk</a>, and <a rel="noopener" href="https://sdlegislature.gov/Legislators/Profile/4831/Detail">Weems</a>

Limits and Unknowns

• This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Official Summary Text

establish provisions for the coverage of nonopioid prescription drugs.
Official keyword topics:
Health Care
Health Maintenance Organizations
Insurance
Official sponsor note: Representatives <a rel="noopener" href="https://sdlegislature.gov/Legislators/Profile/4793/Detail">Mulder</a> (prime), <a rel="noopener" href="https://sdlegislature.gov/Legislators/Profile/4749/Detail">Emery</a>, <a rel="noopener" href="https://sdlegislature.gov/Legislators/Profile/4753/Detail">Goodwin</a>, <a rel="noopener" href="https://sdlegislature.gov/Legislators/Profile/4789/Detail">Moore</a>, <a rel="noopener" href="https://sdlegislature.gov/Legislators/Profile/4791/Detail">Muckey</a>, <a rel="noopener" href="https://sdlegislature.gov/Legislators/Profile/4824/Detail">Uhre-Balk</a>, and <a rel="noopener" href="https://sdlegislature.gov/Legislators/Profile/4831/Detail">Weems</a>

Current Bill Text

26.640.9 101st Legislative Session 1085

2026 South Dakota Legislature
House Bill 1085

Introduced by: Representative Mulder

Underscores indicate new language.
Overstrikes indicate deleted language.
An Act to establish provisions for the coverage of nonopioid prescription drugs. 1
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF SOUTH DAKOTA: 2
Section 1. That a NEW SECTION be added to chapter 58-17: 3
A policy of health insurance subject to this chapter and delivered, issued for 4
delivery, or renewed in this state, may not deny coverage of a nonopioid prescription drug 5
in favor of an opioid prescription drug if a licensed physician or other authorized health 6
care practitioner has prescribed a nonopioid drug for the treatment of pain. 7
A health insurer may not, for a clinically appropriate nonopioid drug, establish prior 8
authorization requirements, step therapy requirements, or other utilization controls, that 9
are more restrictive or extensive than the least restrictive or extensive requirements or 10
controls applicable to any clinically appropriate opioid or narcotic drug or other controlled 11
substance. 12
If a health insurer maintains a formulary that groups prescription drugs into tiers 13
for the purpose of cost sharing, the insurer may not place any nonopioid drugs on a tier 14
with a cost sharing responsibility that exceeds the lowest cost sharing responsibility 15
required for any opioid or narcotic drug. 16