{"data":{"id":"us-sd/sdcl-58-29e-13","jurisdiction":"us-sd","citation":"SDCL § 58-29E-13","heading":"Certain claims adjustments prohibited.","body":"A pharmacy benefit manager may not, directly or indirectly, retroactively adjust a claim for reimbursement submitted by a pharmacy for a prescription drug, unless:\n(1) The adjustment is necessitated by a pharmacy audit conducted in accordance with chapter 58-29F;\n(2) The adjustment is necessitated by a technical billing error;\n(3) The original claim was found to have been fraudulently submitted; or\n(4) The claim submission was a duplicate for which the pharmacy had already received payment.","path":["TITLE 58. INSURANCE","CHAPTER 58-29E. PHARMACY BENEFITS MANAGEMENT"],"source_url":"https://sdlegislature.gov/Statutes/58-29E-13","current_through":"2026-08-31","vintage":"","retrieved_at":"2026-09-03T15:18:57Z","sha256":"cd37a06c0b6d4b489fdb80dc1d0431163822dc6bb602fb34e799570a8e680905","source_id":"us-sd","stale":true,"prev":"us-sd/sdcl-58-29e-12","next":"us-sd/sdcl-58-29e-14"},"notice":"GroundRules: Original legal text. Not legal advice."}