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PBM and Payer Resources

PBM Reform in South Dakota 

South Dakota Pharmacists Association advocates for meaningful pharmacy benefit manager (PBM) reform that benefits patients and pharmacies together. SDPhA supports efforts in PBM oversight on the federal and state level. We work closely with our South Dakota Congressional Delegation, the South Dakota Legislature, the South Dakota Division of Insurance and other stakeholders to ensure adequate payment and meaningful reform. 

References to current SD law for PBMs are linked on right. Should you know of any PBM in violation of this code, we encourage you to file a complaint (link left and below) with the South Dakota Division of Insurance to help enforce law for which we advocated.

Tips for Filing Complaints:
  • A phone call doesn't do it. You must fill out the complaint form. 
  • Include a clear and concise description of the non-compliance (i.e., state law prohibits clawbacks and PBMs continue to clawback funds after the point of sale).
  • Cite the specific state statute (list on the right).
  • Include records/claim/other evidence of the PBMs' violations.
  • Include all other information required by the state's complaint form.
  • Quantity is important, but quality is too - please make sure you have all the necessary documentation for each complaint.