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67:54:03:07Utilization review.

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

Services provided by an ICF/IID are subject to utilization review on the following four levels: (1) At the time of eligibility determination; (2) After discharge from a hospital; (3) During claims processing; or (4) At the annual classification and review.

Source: 18 SDR 224, effective July 13, 1992; 37 SDR 133, effective January 18, 2011; 40 SDR 122, effective January 8, 2014.

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