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SD 943

An Act to prevent inappropriate denials by insurers for medically necessary services

194th Legislature (2025-2026) Introduced by John Keenan

SD 943 prohibits insurers from denying medically necessary care without valid reason, creates an appeals process, and mandates transparency to protect patients from unfair denials.

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Bill Summary · SD 943

Summary of SD 943: An Act to Prevent Inappropriate Denials by Insurers

Overview

SD 943 is a proposed bill that aims to address the issue of inappropriate denials of medically necessary services by health insurance providers. The bill is intended to protect patients from having vital healthcare coverage and treatments unfairly restricted or denied by their insurance companies.

Key Provisions

The main components of SD 943 include:

  1. Prohibited Denial Practices: The bill would prohibit insurance providers from denying coverage for medically necessary services and treatments without a clinically valid reason. Insurers would be required to base coverage decisions on established medical evidence and guidelines.

  2. External Review Process: The legislation would establish an independent external review process for patients to appeal insurance denials. This would give consumers a pathway to have coverage decisions reviewed by qualified, unbiased medical experts.

  3. Transparency Requirements: Insurers would be mandated to clearly disclose their coverage criteria and decision-making processes to policyholders. This aims to improve transparency and accountability around insurance denial practices.

  4. Penalties for Non-Compliance: The bill would empower state insurance regulators to impose financial penalties on insurers that repeatedly issue inappropriate denials or fail to comply with the new transparency requirements.

Potential Impact

If enacted, SD 943 could have several significant impacts:

  • Protect patients from being wrongfully denied medically necessary care that their insurance should cover
  • Provide consumers with a formal avenue to appeal unfair insurance decisions
  • Increase transparency around insurers' coverage policies and denial practices
  • Incentivize insurance companies to improve their utilization review processes and adhere to evidence-based standards
  • Potentially reduce the financial and healthcare burdens on patients who currently face challenges getting their necessary treatments approved

Timeline and Next Steps

SD 943 was introduced in the state legislature on November 29, 2025 and has been referred to the Senate Committee on Health and Human Services for initial review. The committee will need to hold hearings, hear testimony, and vote on whether to advance the bill for further consideration by the full state Senate.

If the bill passes the Senate, it would then proceed to the House of Representatives for additional legislative action before potentially reaching the governor's desk for final approval. The full legislative process could take several months to a year or more to complete.

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

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