This bill establishes a new health care data system overseen by the Division of Insurance in South Dakota, requiring insurers and third-party administrators to submit medical, dental, and pharmaceutical claims data. The data will be utilized for various purposes, including health care planning, policy development, quality assessment, and public health objectives. The bill outlines specific definitions for "insurer" and "third-party administrator," mandates the submission of claims data for certain health plans, and allows for civil penalties for non-compliance. Additionally, it stipulates that claims data from self-funded employer-sponsored plans can be included if the employer consents.

The bill also repeals several sections of existing law that previously assigned the Department of Health the responsibility for coordinating the health data system. It transfers these responsibilities to the Division of Insurance, which will now handle the establishment, maintenance, and use of the health care data system. The new provisions include rules for data reporting, confidentiality, and public access to claims data, ensuring that individual identities remain protected. Overall, the bill aims to enhance transparency and improve health care services in the state through better data management and accessibility.

Statutes affected:
Introduced, 01/24/2025: 1-43-19, 1-43-20, 1-43-21, 1-43-24, 1-43-31, 1-43-32, 1-43-33