Executive Order 2011-23
The South Dakota Medicaid Pharmaceutical & Therapeutics Committee shall:
1) Work with the Department of Social Services in addressing the high costs of prescription drugs, the increased expenditures for those prescription drugs, and the need to find ways to control the costs of prescription drugs while ensuring the needs of recipients are being met.
2) Provide expertise and direction to the Department of Social Services in matters relating to the drugs being used by our recipient population including, but not limited to establishing a prior authorization program, instituting quantity limits, establishing restrictions on early refills, mandating the use of generic drugs, amending the co-pay requirements, investigating state buying pools, considering the coverage of certain over-the-counter medications, developing a preferred drug list, and working with a pharmacy benefit manager to establish a prior authorization program for certain selected drugs.
3) Make recommendations to the Department of Social Services in the development and maintenance of a list of drugs that will require prior authorization before being dispensed for any medically accepted indication.
4) Ensure that interested parties have an opportunity to present public testimony with information or evidence supporting inclusion of a product for prior authorization.
5) Analyze and consider the recommendations of interested parties and the potential impact of a decision to require prior authorization of a drug for individuals covered by the Medicaid Program under the provisions of SDCL 28-6.
6) Develop its recommendations of drugs to be placed on the prior authorization program by considering the clinical efficacy, safety, and cost effectiveness of a product.
Department of Social Services (DSS) is the designated State Medicaid Agency for South Dakota. The Division of Medical Services within the Department administers assistance to those who qualify for Medicaid or the Children’s Health Insurance Program (CHIP).
The Governor of the State of South Dakota may appoint as many members as he/she deems necessary to accomplish the goals of this committee.
Term of Appointment:
No term limits
Frequency of Meetings:
The Board meets quarterly.
Are Members Allowed to Call into Meetings:
Department of Social Services | Division of Medical Services | 700 Governors Drive | Pierre, South Dakota 57501-2291 | 605.773.3495 | DSSBoards&Commissions@state.sd.us
To ensure cost effective prescription drug services are available for South Dakota Medicaid recipients.