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Bill

SB 87

address preauthorization requirements for certain health care services and utilization review requirements for certain health benefit plans.

2025 Regular Session Introduced by Sydney Davis and 3 co-sponsors

SB 87 regulates health insurer preauthorization and utilization review processes to balance cost control with patient access to timely medical care.

Withdrawn at the Request of the Prime Sponsor , Passed, S.J. 136
#healthcare #insurance
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Bill Summary · SB 87

Legislative bill overview

SB 87 would modify South Dakota's health insurance regulations by addressing preauthorization requirements and utilization review processes that health plans use to approve medical services. The bill establishes standards for how insurers must handle prior approval requests from healthcare providers and patients seeking coverage for certain procedures and treatments.

Why is this important

Preauthorization delays can prevent patients from accessing timely medical care, while overly permissive rules may increase insurance costs. This bill attempts to balance insurer cost-control mechanisms with patient access needs—a significant practical issue affecting both healthcare delivery and insurance affordability in the state.

Potential points of contention

  • Definition scope: Disagreement over which services should require preauthorization and which should be expedited or exempted could affect both patient access and insurance premiums
  • Timeline requirements: Disputes over reasonable decision-making timelines (what constitutes "timely" approval) between insurers wanting flexibility and providers/patients wanting quick determinations
  • Insurance cost impact: Industry concerns that stricter preauthorization standards could increase claim approval rates and drive up premium costs for consumers

Compiled from official sources — confirm details with the bill’s official record.

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