Healthcare

HB 1274 prohibits the delivery or distribution of abortion-inducing medicine, drugs, or substances into South Dakota for purposes of an illegal abortion, with exceptions for self-administration by a pregnant person, life-saving medical procedures, or miscarriage management. It establishes a Class 6 felony for violating this prohibition, imposes civil penalties up to $10,000 per dose, and allows civil lawsuits for wrongful death of an unborn child by specific parties (e.g., parents, the pregnant person, or their estate). The bill directly affects medical providers, pharmacies, and anyone transporting such substances into the state, while exempting individuals acting in self-defense or under medical necessity. The attorney general may seek injunctions to stop violations and collect civil penalties for deposit into a state fund.

HB 1257 redefines "abortion" in South Dakota law to include any action intending to terminate a pregnancy with knowledge it will likely cause the unborn child's death, while excluding specific medical treatments (like miscarriage care, ectopic pregnancy treatment, or procedures to save the unborn child's life). It requires physicians to determine that a pregnancy poses a "reasonably foreseeable risk of death" to the mother before permitting an abortion, mandates attempts to preserve both lives when possible, and mandates hospital-based reporting to the Department of Health. The bill directly affects pregnant individuals, physicians, and hospitals by setting strict medical criteria for legal abortions and prohibiting abortions based solely on psychological conditions or self-harm fears. It does not criminalize all abortions but creates a narrow exception for life-threatening conditions, with violations classified as Class 6 felonies.

SB 211 prohibits ambulance providers from billing patients for out-of-network emergency services beyond required coinsurance, copayments, or deductibles. It requires health insurance plans to reimburse out-of-network ambulance providers at local rates (or 325% of Medicare rates if no local rate exists) within 30 days, and mandates clear billing explanations for patients. The law also establishes a complaint process through the Division of Insurance for violations and requires the division to post reimbursement rates online by 2027. It excludes self-funded employer plans, Medicaid, Medicare, and other federally regulated programs from these rules.