Verified October 10, 2026 against the statutes, regulations and sources cited below. General information, not legal advice. All states
What providers miss in South Dakota
- South Dakota's any willing provider law expressly reaches the state Medicaid program, which is rare.
- The law protects a provider who meets the plan's terms; the plan still sets those terms.
Does South Dakota have an any willing provider law?
No health insurer, including South Dakota Medicaid, may exclude a South Dakota-licensed provider located in the plan's coverage area who is willing and fully qualified to meet its terms of participation. Voters adopted it as Initiated Measure 17 in 2014. Self-funded ERISA plans are excluded.
- Any willing provider law
Citation: S.D. Codified Laws 58-17J-1, 58-17J-2
How long can a plan take to credential a provider in South Dakota?
The insurer must decide within 90 days of a complete application and itemize missing items within 30 days of an incomplete one. A special review triggered by licensing, malpractice, criminal or similar issues can take longer.
- Deadline: 90 days
- Applies to: Health insurers and entities credentialing on their behalf
Citation: 2014 S.D. HB 1157
Will the South Dakota insurance department take a provider complaint?
- South Dakota Division of Insurance
Who oversees Medicaid managed care plans in South Dakota?
- South Dakota Department of Social Services (South Dakota Medicaid)
Turned down by a plan in South Dakota?
We read the denial, check which of these rules reach that plan, and prepare the reconsideration request, the access-gap evidence and any regulator complaint the law supports; you sign and send them, and we track every deadline. Self-funded employer plans follow federal law, not South Dakota's. A rejection review is $249, credited toward a dispute.