67:16:48:08.  Treatment for a substance use disorder -- Out-of-state. Out-of-state treatment for a substance use disorder is limited to those services provided in a facility which is licensed or accredited in another state as a substance use disorder treatment facility. Treatment is covered if the following additional requirements are met:

 

          (1)  An addiction counselor within that state completes an integrated assessment and sends the completed assessment to the division. The assessment must include a biopsychosocial history with appropriate testing instrument scores, indicate a diagnosis of a substance use disorder, and contain the credentials of the counselor completing the assessment;

 

          (2)  For intensive inpatient treatment or psychiatric residential treatment, a physician or other licensed practitioner refers the recipient for placement in, transfer to, or continued stay in a substance use disorder treatment program;

 

          (3)  The division authorizes the treatment, and no appropriate in-state treatment is available; and

 

          (4)  The psychiatric residential treatment provided meets the prior authorization requirements found in § 67:16:48:06.

 

          Out-of-state outpatient services do not require prior authorization when provided within 50 miles of the South Dakota border.

 

          Source: 43 SDR 80, effective December 5, 2016; 44 SDR 94, effective December 4, 2017; 44 SDR 192, effective July 2, 2018.

          General Authority: SDCL 28-6-1(1)(2).

          Law Implemented: SDCL 28-6-1(1)(2).