For OS X 10.10 there is no solution for getting smart card to work and for 10.6 - 10.9 one should install an external package to get it running. All this is undocumented and we need to add it to our tag. Bug #3748 comment #9 has background information about the issues.
http://smartcardservices.macosforge.org/ doesn't provide a package for OS X 10.10
Ludovic Rousseau hints that this should be included with the OS (albeit old versions): http://ludovicrousseau.blogspot.se/2011/08/mac-os-x-lion-and-smart-cards-status.html http://ludovicrousseau.blogspot.se/2013/10/os-x-mavericks-and-smart-cards-status.html http://ludovicrousseau.blogspot.se/2014/07/os-x-yosemite-beta-and-smart-cards.html
(In reply to comment #1) > http://smartcardservices.macosforge.org/ doesn't provide a package for OS X > 10.10 They have a package for 10.10 now. However, it actually works on 10.10 without this addon, although somewhat unstable, at least with our Gemalto Prox-DU reader. This *seems* to work: 1) Make sure the reader LED blinks. If necessary, unplug+plug the USB connector. 2) Reboot.
This seems to have been fixed somewhere as macOS 10.15 has smart card support of out box. The last version of Smart Card Services is for 10.12, so it was likely changed somewhere around then.