58-29E-13. Certain claims adjustments prohibited.A pharmacy benefit manager may not, directly or indirectly, retroactively adjust a claim for reimbursement submitted by a pharmacy for a prescription drug, unless:(1)The adjustment is necessitated by a pharmacy audit conducted in accordance with chapter 58-29F;(2)The adjustment is necessitated by a technical billing error;(3)The original claim was found to have been fraudulently submitted; or(4)The claim submission was a duplicate for which the pharmacy had already received payment. Source: SL 2019, ch 213, §2; SL 2023, ch 166, §13.
South Dakota Legal Code