SDCL § 58-29E-13: Certain claims adjustments prohibited.

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.