South Dakota
LLC
Website link to register:
https://sdsos.gov/business-services
Naming conventions
Restricted words must receive approval from regulatory agencies. Must include “Limited Liability Company,” “LLC,” or “L.L.C.” PLLCs apply to licensed medical practices.
Licensing Requirements
All members must hold valid medical licenses from the South Dakota Board of Medical and Osteopathic Examiners. Malpractice insurance mandatory. Facility compliance with South Dakota Department of Health standards required.
Required documentation for medical practices
Articles of Organization, Facility Standards Compliance, Professional Licenses, Malpractice Insurance
Filing Fee: $150
Annual/Biennial Fee: $50
Additional Notes: Annual report due on LLC anniversary date.
Medicaid
Program Name: South Dakota Medicaid
Official Website: https://dss.sd.gov/medicaid/
Legislation: South Dakota does not have specific DPC legislation; practices operate under general healthcare and insurance laws.
Private Contracting
Permitted; DPC practices should ensure compliance with state insurance regulations to avoid being classified as insurers.
Restrictions
No explicit restrictions for DPC providers; compliance with federal and state regulations is necessary.
Medicaid Program
South Dakota Medicaid provides health coverage to eligible low-income residents, including children.
Notification Requirements
Notification strongly recommended for Medicaid patient clarity.
Provider Enrollment Requirements
Providers must enroll with South Dakota Medicaid to serve beneficiaries directly or offer reimbursable services.
Enrollment Options
No "Ordering and Referring Only" status available.
Ordering, Referrals, and Testing
Non-enrolled providers may face challenges with Medicaid recognition for orders and referrals.
Designated PCP Restrictions
DPC physicians cannot act as Medicaid PCPs.
Billing and Reimbursement
DPC practices typically do not bill Medicaid for services covered under private agreements.
Managed Care Plan Exemptions
Not specified.
Billing Clarity
Cannot bill Medicaid patients for covered services unless explicitly outlined.
CMS Guidance
CMS encourages streamlined enrollment for non-billing providers.
Opportunities for Collaboration
Opportunities may exist to collaborate with Medicaid Managed Care Organizations (MCOs) or state programs aimed at improving access to care.
State-Specific Notes
Collaboration opportunities exist with South Dakota Medicaid for expanding primary care.
Dispensing Medication
Board of Pharmacy Official Link: https://doh.sd.gov/boards/pharmacy/
State Licensing
Physicians must register with the South Dakota Board of Pharmacy to dispense controlled substances.
Scope of Practice
Direct dispensing is allowed for both non-controlled and controlled substances under strict state regulations.
Inventory Management
Secure storage and detailed inventory tracking are required for all medications.
Record-Keeping
Records must comply with South Dakota state and federal laws, including HIPAA compliance.
Dispensing Standards
Labels must meet South Dakota Board of Pharmacy standards, including patient name, prescriber details, and dosage.
Controlled Substances
DEA registration and reporting to South Dakota’s PDMP are mandatory for controlled substances.
Billing and Reimbursement
Billing practices must adhere to South Dakota-specific regulations and federal anti-kickback statutes.
Federal Compliance
Compliance with FDA, DEA, and OSHA standards is required for dispensing.
State Pharmacy Laws
Physicians must comply with South Dakota Board of Pharmacy laws for controlled substances dispensing.
Patient Consent
Patient consent must be obtained before dispensing medications.
Insurance and Liability
Physicians must ensure liability insurance covers risks associated with dispensing practices.
Training Requirements
Continuing education for controlled substances dispensing is encouraged in South Dakota.
Audits and Inspections
Inspections are conducted by the South Dakota Board of Pharmacy, with penalties for non-compliance.