67:16:09:06Utilization review.
Section · Administrative Rules of South Dakota · View on sdlegislature.gov ↗
Rulemaking activity
Utilization review of services covered under this chapter may be conducted on any of the following three levels: (1) Computerized claims processing; (2) Postpayment review; and (3) Peer reviews.
Source: SL 1975, ch 16, § 1; 1 SDR 77, effective May 29, 1975; repealed, 3 SDR 26, effective October 6, 1976; readopted, 5 SDR 109, effective July 1, 1979; 7 SDR 66, 7 SDR 89, effective July 1, 1981; 16 SDR 227, effective June 24, 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 oAmended by HB1229 (2019) — require optional services through Medicaid to be authorized through special apprAmended 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 oAmended by HB1229 (2019) — require optional services through Medicaid to be authorized through special apprAmended by SB30 (2019) — remove certain unnecessary federal references and dates from certain provisions