67:16:02:07Utilization review for physician, laboratory,

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

Rulemaking activity

Article 67:15 (LIEAP), Article 67:16 (MS - Transportation) Article 67:18 (Child Support Enforcement), Article 67:42 (Family Foster Homes), Article 67:46 (Economic Assistance)Effective
Chapter 67:16:02 and Chapter 67:16:37. Medical ServicesEffective

and X-ray services. Utilization review for physician, laboratory, and X-ray services may be provided on three levels: (1) Computerized claims processing; (2) Postpayment reviews; and (3) Peer review.

Source: SL 1975, ch 16, § 1; 7 SDR 66, 7 SDR 89, effective July 1, 1981; 16 SDR 234, effective July 2, 1990.

General Authority

SDCL 28-6-1 ↗
Amended by HB1239 (2020) — require the costs of nursing homes to be rebased every five years for purposes o
Amended by HB1229 (2019) — require optional services through Medicaid to be authorized through special appr
Amended by SB30 (2019) — remove certain unnecessary federal references and dates from certain provisions

Law Implemented

SDCL 28-6-1 ↗
Amended by HB1239 (2020) — require the costs of nursing homes to be rebased every five years for purposes o
Amended by HB1229 (2019) — require optional services through Medicaid to be authorized through special appr
Amended by SB30 (2019) — remove certain unnecessary federal references and dates from certain provisions

← 67:16:02:06 67:16:02:08 →