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67:16:28:08Utilization review.

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

Utilization review for ASC services shall be provided by the following: (1) Computerized claims processing; (2) Postpayment monitoring; and (3) Peer review.

Source: 11 SDR 86, effective December 30, 1984; 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