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20:06:13:68Network restrictions.

Section · Administrative Rules of South Dakota · View on sdlegislature.gov ↗

A Medicare select policy or certificate may not restrict payment for covered services provided by providers outside the network if: (1) The services are for symptoms requiring emergency care or are immediately required for an unforeseen illness, injury, or a condition; and (2) It is not appropriate given specific circumstances, such as time or distance, to obtain such services through a network provider.

Source: 22 SDR 107, effective February 18, 1996; 23 SDR 236, effective July 13, 1997.

General Authority

Law Implemented