MedicaidAdministrativeMedium impact
Fall Provider Newsletter
South Dakota Medicaid·SD·Education
Effective date
Jan 1, 2026
We identified it
Jun 21, 2026
Summary
South Dakota Medicaid is implementing major federal changes including work requirements for expanded Medicaid, reduced retroactive coverage periods, and more frequent eligibility checks. Hospital reimbursement methodologies will also be updated in 2026, and the Health Home program is being renamed to Care Connect.
Action Required
By January 1, 2026: Update patient records and billing systems to reflect Health Home program name change to Care Connect. By January 1, 2027: Billing team must verify Medicaid expansion patients (ages 19-64) meet work requirements and understand retroactive coverage is limited to 1 month for expansion enrollees and 2 months for traditional enrollees. Update eligibility verification processes for 6-month redeterminations for expansion patients.