Rule 20:06:40:17.02 Prohibited practices.
20:06:40:17.02. Prohibited practices. A group health plan,
and a health insurance issuer offering group health
insurance coverage in connection with a group health plan, may not:
(1) Deny to a patient
eligibility, or continued eligibility, to enroll or to renew coverage under the
terms of the plan, solely for the purpose of avoiding the requirements of
§ 20:06:40:17; or
(2) Penalize or otherwise
reduce or limit the reimbursement of an attending provider, or provide
incentives (monetary or otherwise) to an attending provider, to induce such
provider to provide care to an individual participant or beneficiary in a
manner inconsistent with § 20:06:40:17.
27 SDR 15, effective September 6, 2000.
Authority: SDCL 58-18-79.
Implemented: SDCL 58-18-79.
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