Our Spring update includes a review of the 2025 South Dakota Legislative Session, a preview of the interim session, and a few federal updates. The South Dakota Legislature wrapped up its 100th Legislative Session with Veto Day on March 31. Going into the legislative session, the SDAHO Advocacy Team was preparing for the worst with 41 new legislators, 38 of them never having served in the past, which created a lot of unknowns. Fortunately, health care was not a major focus of concern during this legislative session and there were several wins in that space.
2025 Legislative Session
Back in December, Governor Kristi Noem proposed her budget for the State with a 1.25% increase that included Medicaid providers, state employees, and school districts. When Lt. Governor Rhoden made his transition to Governor, he supported the proposed budget. To get to that increase, there were cuts included in agencies across the board, including cutting the Graduate Medical Education program, subsidized assisted living funding, and the renal program in Medicaid. The SDAHO Advocacy Team worked with appropriators throughout the run of session to ensure that those cuts were put back into the State budget, which was the final outcome. Additionally, the legislature adopted revenues that included some slight increases, which allowed them to keep the 1.25% increase while putting these items, and a few others, back into the budget. One-time funding in the healthcare space included 2 million dollars for the Recruitment Assistance Programs and $180,000 for sexual assault kits.
On the policy side of things, the SDAHO Advocacy Team was able to defeat 9 of the 10 bills we opposed, including bills that would have:
- required annual drug testing for all hospital employees
- Covid vaccination status for blood donations
- prohibiting directives from the Centers for Disease Control and prevention, and more.
The one bill that passed will place an amendment to the Constitution on the ballot that will allow the State to discontinue Medicaid Expansion should the federal government change the matching rate.
The biggest win on the policy front included a bill to prohibit pharmaceutical manufacturers from interfering with contracts between 340B entities and contract pharmacies. Altogether, the 2025 South Dakota Legislative Session was good for health care in our state.
Looking ahead to the 2025 Interim Session, the SDAHO Advocacy Team will be involved with some upcoming proposed Administrative Rule changes around hospital data and price transparency. The legislature is also moving forward with 2 summer studies that will have an impact on health care. First, lawmakers are going to look at the overall state of the emergency medical services in South Dakota. Several bills have come up to try and address issues in this space in the last couple of years and the legislature has recognized that changes will need to be made in the coming years to support that infrastructure. The second will be a deep dive into the community support provider space in South Dakota. Over the last 5 years, community support providers have received exponentially more funding to their base budget than most state funded entities, so the legislature wants to examine ways to continue to provide those much-needed services in an efficient manner.
Federal Update
A district court in Texas struck down the Centers for Medicare and Medicaid Services minimum nurse staffing rule on April 7. The rule would have required all nursing homes to have an RN onsite 24/7 and set a minimum of 0.55 hours per day for RNS and 2.45 hours per day for nursing assistants. This was a big win for long-term care, which SDHAO has been advocating for over the last year at the federal level. Medicare proposed rules are expected to be coming over the next several months for SNFs, IPPS, OPPS, Home Health, and more. SDAHO will continue to monitor any of these changes and advocate for members at the federal level.
In closing, the SDAHO Advocacy Team will be attending the annual American Hospital Association meeting May 4-7 and will be meeting with our congressional delegation during the trip. If you have any comments or concerns to share with the team, or anything else related to advocacy, please contact Jacob Parsons, Director of Advocacy and Reimbursement.
