<html> <head> <title>Rule 67:54:07:17 Utilization review.</title> <META NAME="Keywords" Content="Administrative Rules 67:54:07:17"> <META NAME="Description" Content="Administrative Rules 67:54:07:17 Utilization review."> <meta name=Generator content="Microsoft Office HTML Filter 2.0"> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Originator content="Microsoft Word 10"> <style> <!-- --> </style> </head> <body lang=EN-US> <div> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>67:54:07:17.&nbsp;&nbsp;Utilization review.</b> The utilization review team must conduct, at least annually, an on-site review to determine whether the TBI program is an appropriate placement; whether the services delivered are appropriate for the client, meet the client's needs, and have assisted the client to live independently in the community; whether the needed services have been provided in a timely and efficient manner; and whether the provider has the staff and facilities to carry out the services identified in the client's rehabilitation plan.</font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The utilization review team must submit its written report of the review to the Department of Human Services and the service provider within 30 days after completing the review. The report must include the team's findings and recommendations for corrective action. The service provider has 15 days from receipt of this report to challenge in writing any of the team's findings or recommendations. The Department of Human Services shall issue its final report within 40 days following receipt of the initial report. The Department of Human Services shall specify in the final report the time within which the provider must institute any required corrective action.</font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 23 SDR 8, effective July 21, 1996.</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-1">28-6-1.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Law Implemented:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-1">28-6-1.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html>