State of South Dakota

South Dakota Legislature

Administrative Rules

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Rule 67:16:01 GENERAL PROVISIONS

CHAPTER 67:16:01

GENERAL PROVISIONS

Section

67:16:01:01                                       Definitions.

67:16:01:02                                       Transferred.

67:16:01:03                                       Eligibility starting date.

67:16:01:04                                       Choosing a provider.

67:16:01:05                                       Transferred.

67:16:01:06                                       Payment of Medicare buy-in premiums.

67:16:01:06.01                                  Covered services.

67:16:01:06.02                                  Covered services must be medically necessary.

67:16:01:06.03                                  Covered services requiring prior authorization.

67:16:01:07                                       State payment as payment in full -- Individual responsible for payment of noncovered services.

67:16:01:07.01 and 67:16:01:07.02    Transferred.

67:16:01:08                                       Services not covered.

67:16:01:08.01                                  Sterilization services.

67:16:01:09                                       Amount of payment.

67:16:01:10                                       Payment of mileage to provider.

67:16:01:11                                       Payment made to provider.

67:16:01:12                                       Confidential information.

67:16:01:13                                       Identification card.

67:16:01:14                                       Transferred.

67:16:01:15                                       Repealed.

67:16:01:16                                       Uniformity of services.

67:16:01:17                                       Fair hearings.

67:16:01:18                                       Civil rights.

67:16:01:19                                       Utilization review.

67:16:01:20 and 67:16:01:21       Transferred.

67:16:01:22                                       Cost-sharing participants.

67:16:01:23                                       Cost sharing deducted from allowable reimbursement before payment.

67:16:01:24                                       Application of chapter.

67:16:01:25                                       Use of cpt.

67:16:01:26                                       Use of ICD-9-CM.

67:16:01:27                                       Use of HCPCS.

67:16:01:28                                       Rates and procedures subject to review and amendment -- Provider may request review.


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