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67:54:04:25Utilization

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

review. Services provided under this chapter are subject to the following utilization reviews: (1) At the time of eligibility determination; (2) During claim processing; (3) During postpayment reviews; and (4) At the time of the annual redetermination of eligibility.

Source: 10 SDR 79, effective February 1, 1984; transferred from § 67:16:27:22, effective August 23, 1992; 26 SDR 150, effective May 21, 2000; SL 2013, ch 128, § 19, effective July 1, 2013.

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