67:16:14:08Utilization review.
Section · Administrative Rules of South Dakota · View on sdlegislature.gov ↗
Utilization review for prescription drug services may be conducted on three levels: (1) Computerized claims processing; (2) Postpayment review; and (3) Peer review.
Source: SL 1975, ch 16, § 1; 1 SDR 77, effective May 29, 1975; 7 SDR 66, 7 SDR 89, effective July 1, 1981; 9 SDR 164, effective June 30, 1983; 16 SDR 234, effective July 1, 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