SD HB1153

Healthcare providers may refuse to participate in or pay for medical services that violate their ethical, moral, or religious beliefs, with "conscience" defined broadly to include organizational governing documents for entities

"Healthcare provider" is defined expansively to include individual practitioners (physicians, nurses, pharmacists, counselors, researchers, students), healthcare organizations, and entities that pay for or arrange medical services (insurers, health plans, employers)

Providers are protected from discrimination, retaliation, or adverse employment actions for exercising conscience rights, engaging in protected speech, or reporting suspected violations to authorities

State agencies including the Department of Health and medical licensing boards cannot sanction providers for First Amendment-protected speech unless they prove by clear and convincing evidence the speech directly harmed a patient within three years; complaints must be provided to providers within 21 days or a $500/day penalty applies

Aggrieved parties may file civil lawsuits seeking injunctive relief, damages, and attorney fees, while providers are shielded from administrative, civil, or criminal liability for conscience-based refusals; the law explicitly does not conflict with federal EMTALA emergency care requirements