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67:16:13:06Utilization review.

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

Utilization review for mental health center and clinic services may be conducted on the following levels: (1) Computerized claims processing; (2) Postpayment review; and (3) Peer reviews.

Source: 4 SDR 88, effective June 26, 1978; 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