<html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><title></title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s865c527e-adef-4885-b1a5-4d5a6a076b4fP0 { margin-top: 0; margin-bottom: 0; margin-left: 0; margin-right: 0; text-indent: 0.00in; text-align: justify; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; } span.s865c527e-adef-4885-b1a5-4d5a6a076b4fC0 { color: #000000; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000000 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000001 { color: #000000; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s865c527e-adef-4885-b1a5-4d5a6a076b4f000002 { color: #000000; background: white; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:01:08"><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000000">67:16:01:08</span></a><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000001">.  Services not covered.</span><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0"> In addition to items and services specified as not covered in other sections of this article, the following items and services are not covered under the medical assistance program:</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (1)  Items or services which have been determined by the state dental or medical consultant or through peer reviews to be not medically necessary, safe, or effective;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (2)  Items or services for which the recipient has no legal obligation to pay or which are charges imposed by immediate relatives or members of the recipient's household;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (3)  Over-the-counter drugs, home remedies, food supplements, nutritional items, vitamins, or alcoholic beverages</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">,</span><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0"> except as covered under chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:14"><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003">67:16:14</span></a><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0"> or </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:42"><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003">67:16:42</span></a><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (4)  Diagnosis or treatment given in the absence of the patient;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (5)  Cosmetic surgery to improve the appearance of an individual</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">, if</span><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0"> not incidental to prompt repair following an accidental injury or any cosmetic surgery </span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">t</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">h</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">at</span><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0"> goes beyond that which is necessary </span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">t</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">o improve the functioning of a malformed body member;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (6)  Items or services provided by practitioners or agencies in the employ of or under contract with the federal, state, or local government, except state institutions for the developmentally disabled </span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">t</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">h</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">at</span><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0"> are certified as skilled nursing or intermediate care facilities, the state psychiatric hospital, the public health service, or the national health service;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (7)  Organ transplants</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">,</span><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0"> except as authorized under chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:31"><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003">67:16:31</span></a><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (8)  Acupuncture;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (9)  Biofeedback;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (10)  Chronic pain rehabilitation program services or chronic pain management services</span><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">, </span><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">except as allowed under chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:14"><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003">67:16:14</span></a><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (11)  Alcohol and drug rehabilitation therapy, except for services provided under chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:48"><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003">67:</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003">16</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003">:</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003">4</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003">8</span></a><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (12)  Procedures for implanting an embryo;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (13)  Gastric bypass, gastric stapling, gastroplasty, any similar surgical procedure, or the associated conservative weight loss management unless prior authorized;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (14)  Self-help devices, exercise equipment, protective outerwear, personal comfort services or environmental control equipment, such as air conditioners, humidifiers, dehumidifiers, heaters, or furnaces;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (15)  Medical equipment for a resident in a health care facility, except as authorized under chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:44:03"><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003">67:44:03</span></a><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (16)  Autopsies;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (17)  Custodial care, except as authorized under chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:44:03"><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003">67:44:03</span></a><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (18)  Nursing facility services for individuals age 21 and over and under age 65 in institutions for mental disease;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (19)  Broken appointments;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (20)  Reports required solely for insurance or legal purposes unless requested by the department, the Department of Health, or the Department of Human Services;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (21)  Concurrent care by more than one provider of the same discipline for the same diagnosis without a medical referral detailing the medical necessity of the concurrent care. For concurrent care without medical referral, the department will pay only the first claim submitted;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (22)  A health service that is not documented in the recipient's medical record as required by chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:34"><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003">67:16:34</span></a><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (23)  Vocational training, educational activities, teaching, or counseling, except outpatient diabetes self-management education programs covered under chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:46"><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003">67:16:46</span></a><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (24)  Record keeping, charting, or documentation related to providing a covered service, unless specifically allowed in this article;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (25)  Payment of mileage unless specifically covered under this article;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (26)  Drugs and biologicals</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">,</span><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0"> which the federal government has determined to be less than effective</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">,</span><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0"> as listed in § </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:14:05"><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003">67:16:14:05</span></a><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (27)  Services, procedures, or drugs</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">,</span><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0"> which are considered experimental by the United States Department of Health and Human Services or another federal agency</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">, not including services, procedures, or drugs approved by the Food and Drug Administration under an emergency use authorization that are being utilized in accordance with the emergency use authorization</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (28)  Procedures and services to reverse sterilization;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">29</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">)  Computers, computer hookups, or computer printers</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">,</span><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0"> unless prior authorized;</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (3</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">0</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">)  Gambling addiction services or therapy; and</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    (3</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">1</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">)  Penile implants.</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    </span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000001">Source:</span><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0"> SL 1975, ch 16, § 1; 7 SDR 23, effective September 18, 1980; 7 SDR 66, 7 SDR 89, effective July 1, 1981; 9 SDR 11, effective August 1, 1982; 9 SDR 164, effective June 30, 1983; 10 SDR 79, effective February 1, 1984; 11 SDR 26, effective August 21, 1984; 11 SDR 86, effective December 30, 1984; 15 SDR 204, effective July 6, 1989; 17 SDR 4, effective July 16, 1990; 17 SDR 184, effective June 6, 1991; 17 SDR 194, effective June 24, 1991; 18 SDR 98, effective December 9, 1991; 19 SDR 26, effective August 23, 1992; 19 SDR 165, effective May 3, 1993; 20 SDR 144, effective March 10, 1994; 22 SDR 32, effective September 11, 1995; 28 SDR 166, effective June 12, 2002; 35 SDR 88, effective October 23, 2008; 40 SDR 122, effective January 7, 2014</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">; 43 SDR 80, effective December 5, 2016; 46 SDR 50, effective October 10, 2019; 47 SDR 129, effective June 3, 2021.</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    </span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000001">General Authority:</span><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=28-6-1"><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003">28-6-1</span></a><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">(1)(2)</span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">.</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    </span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000001">Law Implemented:</span><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=28-6-1"><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003">28-6-1</span></a><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">.</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">    </span><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000001">Cross-Reference:</span><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0"> Covered services must be medically necessary, § </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:01:06.02"><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0-000003">67:16:01:06.02</span></a><span class="s865c527e-adef-4885-b1a5-4d5a6a076b4fC0">.</span></p><p dir="ltr" class="s865c527e-adef-4885-b1a5-4d5a6a076b4fP0"><span xml:space="preserve" class="s865c527e-adef-4885-b1a5-4d5a6a076b4f000002"> </span></p></div></body></html>