Relevant Contact Points in South Dakota

The state survey and licensing authority for hospitals, nursing facilities, assisted living centers, community living homes, residential living centers, home health agencies, hospice, ambulatory surgical centers, ESRD facilities, organ transplant programs and birthing centers. The office also has regional managers for the Rapid City/Pierre/Mitchell and Sioux Falls regions, not individually named.

Provides information, referral assistance and rights education for residents of nursing facilities, assisted living facilities, licensed adult foster care homes and community living homes; it does not regulate providers, but works to resolve resident concerns and protect their health, rights, safety and welfare. The page cites the Nursing Home and Assisted Living Center Bill of Rights at ARSD ch. 44:73:11 and ch. 44:70:09.

South Dakota's Medicaid Fraud Control Unit; investigates and prosecutes health care providers who defraud the state's Medicaid program, and separately investigates abuse, neglect or financial exploitation of the elderly, sick and disabled by caretakers, including in health care facilities. Staffed by two Assistant Attorneys General, four investigators, two auditors and an administrative analyst.

The Attorney General's general intake for medical-billing scams, discount-medical-plan complaints and deceptive-trade-practices complaints under SDCL chapter 37-24.

The state's designated complaint channel for questions about the No Surprises Act or a surprise medical bill; the page also covers the federal good-faith-estimate right for uninsured or self-pay patients and the dispute-resolution process when a final bill exceeds the estimate by more than $400, confirming South Dakota enforces the federal framework rather than a separate state balance-billing statute.

States its mission to protect the public and make insurance available and affordable, and regulates insurance companies, HMOs, PBMs and other insurance-industry entities under Title 58 and its supporting administrative rules.

Confirms consumers' right to complain against an insurance company, HMO, producer, adjuster or other licensed or registered entity, and directs a consumer disputing coverage or benefits with a health-plan carrier to first exhaust the carrier's internal appeals process before filing a Division complaint.

Confirms that pharmacy benefits managers operating in South Dakota must be licensed as third-party administrators under chapter 58-29D, and directs a person who has observed a possibly-noncompliant PBM business practice to file a Pharmacy Benefits Management Complaint form with the Division or call its consumer line.

Lists SHIINE (Senior Health Information and Insurance Education), South Dakota's State Health Insurance Assistance Program, among its consumer-facing programs, alongside the Ombudsman Program and Adult Protective Services, with the Dakota at Home program as the statewide intake line for related in-home-services referrals.

Handles physician, physician assistant and allied-profession licensing and discipline.

The licensure, survey and complaint contact for nursing facilities and other health care facilities.

South Dakota's state-run Aging and Disability Resource Center, a program of the Department of Human Services, and the point of contact for the state's Long-Term Care Ombudsman Program and other elder and long-term-care resident-rights referrals by region.

Regulates securities for the South Dakota Department of Labor and Regulation's Division of Insurance.

The official site of the Office of the South Dakota Attorney General, home to the Division of Consumer Protection.