South Dakota
An obscure drug discount program stifles use of federal lifeline by rural hospitals • South Dakota Searchlight
Facing ongoing concerns about rural hospital closures, Capitol Hill lawmakers have introduced a spate of proposals to fix a federal program created to keep lifesaving services in small towns nationwide.
In Anamosa, Iowa — a town of fewer than 6,000 residents located more than 900 miles from the nation’s capital — rural hospital leader Eric Briesemeister is watching for Congress’ next move. The 22-bed hospital Briesemeister runs averages about seven inpatients each night, and its most recent federal filings show it earned just $95,445 in annual net income from serving patients.
Yet Briesemeister isn’t interested in converting the facility into a rural emergency hospital, which would mean getting millions of extra dollars each year from federal payments. In exchange for that financial support, hospitals that join the program keep their emergency departments open and give up inpatient beds.
“It wasn’t for us,” said Briesemeister, chief executive of UnityPoint Health-Jones Regional Medical Center. “I think that program is a little bit more designed for hospitals that might not be around without it.”
Nationwide, only about two dozen of the more than 1,500 eligible hospitals have become rural emergency hospitals since the program launched last year. At the same time, rural hospitals continue to close — 10 since the fix became available.
Federal lawmakers have introduced a handful of legislative solutions since March. In one bill, senators from Kansas and Minnesota list a myriad of tactics, including allowing older closed facilities to reopen.
Another proposal introduced in the House by two Michigan lawmakers is the Rural 340B Access Act. It would allow rural emergency hospitals to use the 340B federal drug discount program, which Congress created in 1992.
The 340B program, named after its federal statute, lets eligible hospitals and clinics buy drugs at a discount and then bill insurance companies, Medicare, or Medicaid at market rates. Hospitals get to keep the money they make from the difference.
Congress approved 340B as an indirect aid package to help struggling hospitals stay afloat. Many larger hospitals say the cash is used for community benefits and charity care, while many small hospitals depend on the drug discounts to help cover staffing and operational shortfalls.
Currently, emergency hospitals are not eligible for 340B discounts. According to a release from U.S. Rep. Jack Bergman (R-Mich.), the House proposal would “correct this oversight.” Backers of the House bill include the American Hospital Association and the National Rural Health Association.
In Iowa, Briesemeister said the 340B federal drug discount program “can be used for tremendous good.” The small-town hospital uses money it makes from 340B to subsidize emergency services and uninsured and underinsured patients who frequent the emergency department, he said.
Chuck Grassley, Iowa’s longtime Republican senator, shepherded the Rural Emergency Hospital program into law. His spokesperson, Gillie Maddox, did not respond directly to questions about why the federal law creating rural emergency hospitals omitted the 340B program. Instead, Maddox said the designation was a “product of bipartisan negotiations.”
A survey conducted by the health analytics and consulting firm Chartis, along with the National Rural Health Association, found that nearly 80% of rural hospitals had participated in 340B and nearly 40% said they reaped $750,000 or more annually from the program.
Sanford Health, a largely rural health system headquartered in Sioux Falls, South Dakota, considered converting a handful of smaller critical access hospitals into rural emergency hospitals.
Martha Leclerc, vice president of corporate contracting for Sanford, said the system analyzed how much revenue would be lost by closing inpatient beds, which is also a requirement of the emergency hospital program, and by being unable to file for drug discounts.
In the end, she said, switching did not “make a lot of sense.”
Creative thinking needed to save rural hospitals
While many rural hospitals are clamoring for the 340B provision to be added to the rural emergency hospital program, opponents have said 340B can be a cash cow for hospitals that don’t serve enough vulnerable patients.
Nicole Longo is deputy vice president of public affairs for the Pharmaceutical Research and Manufacturers of America, the nation’s largest, most influential pharmaceutical lobbying group. She wrote in a recent blog post that hospital systems and chain pharmacies are “exploiting the program” and said patients have not benefited from the growth in the program.
In an interview, Longo said PhRMA supports rural emergency hospitals being able to access 340B because they are treating “vulnerable patients in underserved communities” and are “true safety net providers.”
PhRMA, she said, wants to encourage a thoughtful conversation about “which types of hospitals should be in the program.” Last year, PhRMA formed an unlikely pact with community health centers to create the Alliance to Save America’s 340B Program, or ASAP 340B.
Vacheria Keys, associate vice president of policy and regulatory affairs at the National Association of Community Health Centers, said, “There is a new day of openness, from all parties.”
Use of the drug discount program skyrocketed after provisions in the Patient Protection and Affordable Care Act, passed in 2010, allowed hospitals and clinics to contract with an unlimited number of retail pharmacies, such as Walgreens and CVS, which are paid a fee to dispense the discounted drugs.
Adam J. Fein, president of the industry research organization Drug Channels Institute, reports that the 340B program is the second-largest federal drug program, trailing Medicare Part D. The flow of drugs purchased under the 340B program reached $53.7 billion in 2022, about $9.8 billion more than in 2021.
In response to the exploding use of contract pharmacies, pharmaceutical manufacturers have restricted the drugs they offer at a discount through the pharmacies. That throttling is affecting rural hospitals like Labette Health, a Kansas hospital whose president asked President Joe Biden for help in dealing with the pharmaceutical companies.
Rena Conti, an associate professor of markets, public policy, and law at Boston University’s Questrom School of Business, has studied the drug discounts for years and said she has “significant worries about expanding” the 340B program.
“There is a lot of money being generated in this program that we really can’t understand exactly how much that really is and exactly who it is benefiting,” Conti said.
At the same time, said Conti, a health care economist, giving rural hospitals access to the federal drug discounts “makes sense because they are hospitals that are serving particularly vulnerable patient populations.”
SIOUX FALLS, S.D. (Dakota News Now) – Nine school districts have been selected as recipients of the 2026 Perkins Reserve Grant by the South Dakota Department of Education.
The grant provides major equipment upgrades for Career and Technical Education programs, helping to equip students with the skills and experiences needed for post-secondary education and the workforce.
“CTE programs are constantly evolving to match the pace of workforce needs,” said Secretary of Education Dr. Joseph Graves.
“The South Dakota Perkins Reserve Grant aids schools in equipping students with current technologies, resources, and tools, offering students a realistic, hands-on learning experience that will strengthen their marketability to colleges or employers once they leave the K-12 education system.”
The following school districts have been named as the 2026 recipients:
- Aberdeen School District:
- Awarded $30,233 for new precision machine equipment for the manufacturing program.
- De Smet School District:
- Awarded $15,898 for modernizing metal fabrication within agriculture programs.
- Lake Preston School District:
- Awarded $43,160 for expansion of program offers in multiple career clusters to strengthen industrial alignment.
- McLaughlin School District:
- Awarded $11,997 to purchase equipment to offer a new culinary arts program.
- Menno School District:
- Awarded $32,844 to purchase small engines and attend professional development opportunities to enhance the agricultural mechanics program.
- Mitchell School District:
- Awarded $38,663 for the modernization of the automotive technology lab.
- Timber Lake School District:
- Awarded $42,400 for the expansion of agriculture course offerings to strengthen industry alignment.
- Wakpala School District:
- Awarded $40,145 to purchase a skid steer simulator to enhance the agriculture and construction program.
- Wolsey-Wessington School District:
- Awarded $26,201 to purchase industry-aligned equipment to enhance the agriculture and construction program.
You can learn more about the South Dakota Perkins Reserve Grant at doe.sd.gov.
Copyright 2026 Dakota News Now. All rights reserved.
The South Dakota Lottery offers multiple draw games for those aiming to win big.
Here’s a look at March 4, 2026, results for each game:
Winning Powerball numbers from March 4 drawing
07-14-42-47-56, Powerball: 06, Power Play: 4
Check Powerball payouts and previous drawings here.
Winning Lotto America numbers from March 4 drawing
33-38-39-47-51, Star Ball: 07, ASB: 02
Check Lotto America payouts and previous drawings here.
Winning Dakota Cash numbers from March 4 drawing
02-18-22-30-32
Check Dakota Cash payouts and previous drawings here.
Winning Millionaire for Life numbers from March 4 drawing
12-13-36-39-58, Bonus: 03
Check Millionaire for Life payouts and previous drawings here.
Feeling lucky? Explore the latest lottery news & results
Are you a winner? Here’s how to claim your prize
- Prizes of $100 or less: Can be claimed at any South Dakota Lottery retailer.
- Prizes of $101 or more: Must be claimed from the Lottery. By mail, send a claim form and a signed winning ticket to the Lottery at 711 E. Wells Avenue, Pierre, SD 57501.
- Any jackpot-winning ticket for Dakota Cash or Lotto America, top prize-winning ticket for Lucky for Life, or for the second prizes for Powerball and Mega Millions must be presented in person at a Lottery office. A jackpot-winning Powerball or Mega Millions ticket must be presented in person at the Lottery office in Pierre.
When are the South Dakota Lottery drawings held?
- Powerball: 9:59 p.m. CT on Monday, Wednesday, and Saturday.
- Mega Millions: 10 p.m. CT on Tuesday and Friday.
- Lucky for Life: 9:38 p.m. CT daily.
- Lotto America: 9:15 p.m. CT on Monday, Wednesday and Saturday.
- Dakota Cash: 9 p.m. CT on Wednesday and Saturday.
- Millionaire for Life: 10:15 p.m. CT daily.
This results page was generated automatically using information from TinBu and a template written and reviewed by a South Dakota editor. You can send feedback using this form.
PIERRE — A bill from South Dakota Attorney General Marty Jackley to criminalize the creation or sharing of deepfakes was amended this week to more clearly define what constitutes nudity before it reaches Gov. Larry Rhoden’s desk.
The amendment, added on the floor of the House of Representatives, came in response to concerns about unintended consequences.
Senate Bill 41 creates a class of felony crime for the creation or distribution of images digitally altered to depict a person in a state of nudity or involved in a sexually explicit act, commonly referred to as deepfakes.
In testimony in the House Judiciary Committee on Monday in Pierre, Jackley pointed to the case of Mark Rathbun, a former Division of Motor Vehicles employee who is accused of taking images of women and girls from state databases and creating sexual images.“This is real, and it’s something that we unfortunately are seeing happen in our state,” Jackley said.
The judiciary committee voted 8-3 to send the bill to the House floor but not before a discussion on its potential to criminalize political memes.
The bill’s definition of nudity originally encompassed a partial state of nudity. Fort Pierre Republican Rep. Will Mortenson asked Jackley if that would include a fabricated topless photo. Jackley said yes. Then Mortenson asked if a fabricated image of Democratic Illinois Gov. J.B. Pritzker without a shirt, if shared by President Donald Trump on social media, would put the president in line for felony charges.
Jackley said a Pritzker image wouldn’t qualify because Pritzker is male, but Mortenson pushed back.
He noted that partially nude fabrications would be a felony if done with the intent to “self-gratify or alarm, annoy, embarrass, harass, invade the privacy of, threaten, or cause emotional, financial, physical, psychological, or reputational harm to that individual.”
Nothing in the bill specified that a person in a digitally fabricated topless image must be female.
“We just said that half-nude is a state of nudity, and so now he’s shirtless, and the point of this is to embarrass this guy,” Mortenson said of his topless Pritzker meme scenario.
Mortenson voted against the bill in committee but brought an amendment Tuesday to define nudity as inclusive of male or female genitalia, buttocks or the female nipple.
The amendment passed, but it did not address every concern about the bill.
Democratic Rep. Kadyn Wittman of Sioux Falls asked Jackley during the bill’s committee hearing why he didn’t use it to enhance penalties for people who film others in states of undress or participating in sexual activity against their will.
That behavior is a felony if it involves the recording of a minor, or if it happens repeatedly. The new penalties for deepfakes would be added to the same chapter of South Dakota law.
“Why is the first time hidden recording a misdemeanor generally, but a digitally fabricated image would automatically be a classified felony,” said Wittman.
Jackley said he feels that the creation of digitally manipulated sexual images, even if they aren’t shared, signals “significant criminal intent.” He told South Dakota Searchlight after the committee meeting that he’s open to addressing that issue, but that SB 41’s primary purpose was to target deepfakes.
On the House floor, Wittman was one of two representatives to say the bill’s felony penalties could be unnecessarily harsh in instances where young people make “a stupid decision” and create a deepfake.
“I feel like, in a lot of situations, this bill covers behavior that could be covered by a lower level of offense,” Wittman said.
Supporters countered that the creation of fake nudes can do real psychological damage to real people, and that the state needs to clearly signal that doing so is a serious crime.
“It’s only fun and games until it happens to you,” said Rep. Mary Fitzgerald, R-St. Onge.
The bill passed the House 60-6. It now moves to the state Senate, which passed the bill 32-0 on Jan. 16. The Senate would need to approve the amended version of the bill before it could be delivered to Gov. Larry Rhoden to sign or veto.
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