South Dakota Codified Laws 58-29E-13. Certain claims adjustments prohibited
Current as of: 2023 | Check for updates
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A pharmacy benefit manager may not, directly or indirectly, retroactively adjust a claim for reimbursement submitted by a pharmacy for a prescription drug, unless:
(1) The adjustment is necessitated by a pharmacy audit conducted in accordance with chapter 58-29F;
(2) The adjustment is necessitated by a technical billing error;
(3) The original claim was found to have been fraudulently submitted; or
(4) The claim submission was a duplicate for which the pharmacy had already received payment.
Source: SL 2019, ch 213, § 2; SL 2023, ch 166, § 13.