HB1292

Health carriers in South Dakota will have up to 18 months from the date of payment to recoup or deny a previously paid insurance claim, but only if they provide written notice to the provider explaining why—with exceptions for fraudulent claims, claims involving other insurance carriers, federal health programs like Medicare and Medicaid, workers' compensation, and duplicate payments. This new rule limits the current practice of health carriers recouping claims after extended periods and establishes enforcement through the state Division of Insurance.

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