SDCL § 58-17H-54: Step therapy protocols--Process--Transparency.
Where this section sits in the code
- TITLE 58. INSURANCE
- CHAPTER 58-17H. UTILIZATION REVIEW AND BENEFIT DETERMINATIONS
When coverage of a prescription drug for the treatment of any medical condition is restricted for use by a health carrier, health benefit plan, or utilization review organization through the use of a step therapy protocol, the covered person and the prescribing health care professional shall have access to a clear, readily accessible, and convenient process to request a step therapy override exception. A health carrier, health benefit plan, or utilization review organization may use its existing medical exceptions process to satisfy this requirement. The process used shall be easily accessible on the internet site of the health carrier, health benefit plan, or utilization review organization.
Collected 2026-09-03T15:18:57Z. Source file · JSON