22:02:02:07. Reasons
for claim denial. The board shall deny a county's claim for reimbursement
for any of the following reasons:
(1) The county has not paid
its CCPR annual assessment;
(2) The county has not paid
its supplemental CCPR fund assessment;
(3) The county has not paid
the first $20,000 for the individual for the 12-month period;
(4) The county has not
provided the evidence required under § 22:02:02:05;
(5) The service was
provided before January 1, 1985;
(6) The service was provided
before the date of county participation;
(7) The county has not been
approved as a participating county;
(8) The request for
reimbursement has been delayed and the county failed to notify the department
according to § 22:02:02:03;
(9) The claim is for an
organ transplant for which the county has failed to meet the requirements of
SDCL 28-13A-13;
(10) The county failed to
follow its guidelines when determining eligibility;
(11) The county failed to
pursue other third-party payment sources;
(12) The individual was not
eligible for county poor relief; or
(13) The claim exceeds the
payment limits established in § 22:02:02:08.
Source:
11 SDR 144, effective May 2, 1985, amended effective July 1, 1985; 19 SDR 76,
effective November 23, 1992; 22 SDR 2, effective July 17, 1995; 25 SDR 69,
effective November 12, 1998; transferred from § 67:19:02:07, 36 SDR 27,
effective August 26, 2009.
General
Authority: SDCL 28-13A-4.
Law
Implemented: SDCL 28-13A-4.