67:45:02:11Utilization review.
Section · Administrative Rules of South Dakota · View on sdlegislature.gov ↗
Claims and payments for nursing facility care, adult foster care, or assisted living are subject to review on the following levels: (1) At the time of admission; (2) Computerized claims review and audit; and (3) Annual care classification review.
Source: 18 SDR 67, effective October 13, 1991; 22 SDR 16, effective August 17, 1995.
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