State of South Dakota
LEGISLATIVE ASSEMBLY, 2012
SENATE BILL NO. 74
Introduced by: Senators Kraus, Bradford, Cutler, Gray, Hansen (Tom), Haverly, Maher,
Schlekeway, and Tieszen and Representatives Munsterman, Abdallah,
Deelstra, Hickey, Lucas, Lust, Novstrup (David), Olson (Betty), Rausch,
Romkema, Sigdestad, Sly, Tornow, Verchio, and Willadsen
FOR AN ACT ENTITLED, An Act to require the direct billing of anatomic pathology services.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF SOUTH DAKOTA:
Section 1. A clinical laboratory or physician, located in this state and providing anatomic
pathology services for patients in this state, may present a claim, bill, or demand for payment
for these services only to the following:
(1) The patient directly;
(2) The responsible insurer or other third-party payor;
(3) The hospital, public health clinic, or nonprofit health clinic ordering such services;
(4) The referring laboratory, excluding a laboratory of a physician's office or group
practice that does not perform the professional component of the anatomic pathology
service for which such claim, bill, or demand is presented;
(5) Governmental agencies or their specified public or private agent, agency, or
organization on behalf of the recipient of the services.
Section 2. Except for a physician at a referring laboratory that has been billed pursuant to
section 6 of this Act, no licensed practitioner in the state may, directly or indirectly, charge, bill,
or otherwise solicit payment for anatomic pathology services unless such services were rendered
personally by the licensed practitioner or under the licensed practitioner's direct supervision in
accordance with section 353 of the Public Health Service Act (42 U.S.C. 263a).
Section 3. No patient, insurer, third party payor, hospital, public health clinic, or nonprofit
health clinic may be required to reimburse any licensed practitioner for charges or claims
submitted in violation of this Act.
Section 4. Nothing in this Act mandates the assignment of benefits for anatomic pathology
services as defined in section 5 of this Act.
Section 5. For purposes of this Act, the term, anatomic pathology services, means:
(1) Histopathology or surgical pathology meaning the gross and microscopic
examination performed by a physician or under the supervision of a physician,
including histologic processing;
(2) Cytopathology meaning the microscopic examination of cells from the following:
(d) Brushings; or
(e) Smears, including the Pap test examination performed by a physician or under
the supervision of a physician;
(3) Hematology meaning the microscopic evaluation of bone marrow aspirates and
biopsies performed by a physician, or under the supervision of a physician, and
peripheral blood smears when the attending or treating physician, or technologist
requests that a blood smear be reviewed by a pathologist;
(4) Sub-cellular pathology or molecular pathology meaning the assessment of a patient
specimen for the detection, localization, measurement, or analysis of one or more
protein or nucleic acid targets;
(5) Blood-banking services performed by pathologists.
Section 6. The provisions of this Act do not prohibit billing of a referring laboratory for
anatomic pathology services in instances whenever a sample or samples must be sent to another
physician or laboratory for consultation or histologic processing for purposes of this section.
However, the term, referring laboratory, does not include a laboratory of a physician's office or
group practice that does not perform the professional component of the anatomic pathology
Section 7. The respective state licensing boards may revoke, suspend, or deny renewal of
the license of any practitioner, under the board's jurisdiction, who violates the provisions of this