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PierreReview

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

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

Rulemaking activity

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
← 67:16:02:0667:16:02:08 →