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Administrative Rules
Rule 20:06:53:15 Independence of review decision.

          20:06:53:15.  Independence of review decision. In reaching a decision, the assigned independent review organization is not bound by any decisions or conclusions reached during the health carrier's utilization review process as set forth in SDCL 58-17H-1 to 58-17H-49, inclusive, or the health carrier's internal grievance process as set forth in SDCL 58-17I-1 to 58-17I-16, inclusive.

 

          Source: 37 SDR 48, effective September 22, 2010; 37 SDR 241, effective July 1, 2011.

          General Authority: SDCL 58-17-87, 58-17H-49, 58-17I-16, 58-18-79.

          Law Implemented: SDCL 58-17-87, 58-18-79.

 

Online Archived History: