67:16:03:06.04Basis of reimbursement -- Inpatient services -- Out-of-state hospitals.

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

The department shall reimburse out-of-state inpatient hospital services using the diagnosis-related group (DRG) methodology established in § 67:16:03:06. Hospital base rates, DRGs, and associated weight factors may be obtained on the department's fee schedule website.

Source: 15 SDR 2, effective July 17, 1988; 16 SDR 235, effective July 5, 1990; 17 SDR 200, effective July 1, 1991; 30 SDR 26, effective September 3, 2003; 31 SDR 107, effective February 1, 2005; 36 SDR 215, effective July 1, 2010; 36 SDR 215 adopted June 11, 2010, effective July 1, 2011; 37 SDR 236, effective June 28, 2011; 38 SDR 224, effective July 1, 2012; 40 SDR 15, effective July 31, 2013; 52 SDR 126, effective July 1, 2026.

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
SDCL 28-6-1.1 ↗
Amended by HB1239 (2020) — require the costs of nursing homes to be rebased every five years for purposes o

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