Healthcare (Medicare)

HB 1292 limits South Dakota health insurance companies' ability to take back payments they've already made for medical services. It requires insurers to provide written notice at least 30 days in advance if they seek to recoup a payment, and restricts such actions to claims paid within the previous 18 months (with exceptions for fraud, Medicare/Medicaid, workers' compensation, or duplicate payments). The bill establishes a dispute resolution process through the Division of Insurance for disagreements, preventing insurers from withholding future payments during the review. This directly affects healthcare providers (like doctors and clinics) who receive payments from insurers and the insurers themselves, applying to claims for services provided on or after July 1, 2026.