MedicaidAdministrativeHigh impact
Billing a Medicaid Recipient
South Dakota Medicaid·SD·Claims & Billing
Effective date
Jul 1, 2024
We identified it
Jun 21, 2026
Summary
South Dakota Medicaid has eliminated copays for medical services as of July 1, 2024, and providers are prohibited from balance billing Medicaid recipients for covered services. Providers must obtain Advanced Recipient Notice forms for non-covered services and cannot bill patients for provider errors.
Action Required
Immediately: Stop collecting copays from all South Dakota Medicaid patients. Update billing system to remove copay requirements for SD Medicaid. Implement Advanced Recipient Notice of Non-Coverage forms for non-covered services. Train staff to never balance bill Medicaid recipients for covered services or provider billing errors. Ensure all other insurance is billed before Medicaid claims submission.