Marcia Hultman

Cabinet Secretary

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Division of Insurance

Consumer Protection for Surprise Bills

Consumers have new protections related to surprise bills—bills received for emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers.

To learn more about these federal No Surprises Act protections, please visit Center for Medicare and Medicaid Services (CMS) No Surprises Act website.

Consumers who have questions regarding the No Surprises Act or believe they have received a surprise bill can contact the South Dakota Division of Insurance.

If a consumer is uninsured or is self-paying, providers need to give good-faith estimates of expected charges in certain circumstances. The good-faith estimate should provide the expected charges for the schedule procedure or service as well as any other related items or services. A dispute resolution process has been established for uninsured or self-paying consumers who receive a bill in excess of $400 over the good-faith estimate.

States have the primary enforcement authority over the new requirements with respect to health insurance issuers, health care providers and facilities, and providers of air ambulance services. View copies of the enforcement letters for each state.

Contact the Division of Insurance