<html> <head> <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"> <title>Rule 67:48 RECOVERIES AND INVESTIGATIONS</title> <META NAME="Keywords" Content="Administrative Rules 67:48"> <META NAME="Description" Content="Administrative Rules 67:48 RECOVERIES AND INVESTIGATIONS"> <style> <!-- --> </style> </head> <body lang=EN-US> <div> <p><b>ARTICLE 67:48</b></p> <p align=center><b>&nbsp;</b></p> <p align=center><b>RECOVERIES AND INVESTIGATIONS</b></p> <p>Chapter</p> <p><a href="DisplayRule.aspx?Rule=67:48:01">67:48:01</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Collection of medical benefits paid in error.</p> <p><a href="DisplayRule.aspx?Rule=67:48:02">67:48:02</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Liens and estate recoveries</p> <p><a href="DisplayRule.aspx?Rule=67:48:03">67:48:03</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Recoveries from providers.</p> <p><a href="DisplayRule.aspx?Rule=67:48:04">67:48:04</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Recoveries from policyholders.</p> <p><a href="DisplayRule.aspx?Rule=67:48:05">67:48:05</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Recoveries -- Child care services</p> </div> </body> </html> <br /><hr><br /><html> <head> <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"> <title>Rule 67:48:01 COLLECTION OF MEDICAL BENEFITS PAID IN ERROR</title> <META NAME="Keywords" Content="Administrative Rules 67:48:01"> <META NAME="Description" Content="Administrative Rules 67:48:01 COLLECTION OF MEDICAL BENEFITS PAID IN ERROR"> <style> <!-- --> </style> </head> <body lang=EN-US> <div> <h1><b>CHAPTER 67:48:01</b></h1> <p align=center><b>COLLECTION OF MEDICAL BENEFITS PAID IN ERROR</b></p> <p>Section</p> <p><a href="DisplayRule.aspx?Rule=67:48:01:01">67:48:01:01</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Definitions.</p> <p><a href="DisplayRule.aspx?Rule=67:48:01:02">67:48:01:02</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Establishing claim against individual -- Medical benefits paid in error.</p> <p><a href="DisplayRule.aspx?Rule=67:48:01:03">67:48:01:03</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Medical benefit not subject to recovery if error made by department.</p> <p><a href="DisplayRule.aspx?Rule=67:48:01:04">67:48:01:04</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Recovery for certain long-term care cases.</p> <p><a href="DisplayRule.aspx?Rule=67:48:01:05">67:48:01:05</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Medical benefit paid in error as result of intentional program violation.</p> <p><a href="DisplayRule.aspx?Rule=67:48:01:06">67:48:01:06</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Administrative hearing to determine whether intentional program violation occurred.</p> <p><a href="DisplayRule.aspx?Rule=67:48:01:07">67:48:01:07</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Notice to individual suspected of committing an intentional program violation.</p> <p><a href="DisplayRule.aspx?Rule=67:48:01:08">67:48:01:08</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Notice of intentional program violation hearing.</p> <p><a href="DisplayRule.aspx?Rule=67:48:01:09">67:48:01:09</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Individual's rights -- Intentional program violation hearing.</p> <p><a href="DisplayRule.aspx?Rule=67:48:01:10">67:48:01:10</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Time frame for holding hearing and writing final decision.</p> <p><a href="DisplayRule.aspx?Rule=67:48:01:11">67:48:01:11</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Postponement of intentional program violation hearing.</p> <p><a href="DisplayRule.aspx?Rule=67:48:01:12">67:48:01:12</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Hearing may be held in absence of accused individual -- Department to conduct new hearing if good cause found for individual's absence.</p> <p><a href="DisplayRule.aspx?Rule=67:48:01:13">67:48:01:13</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Consolidation of hearings.</p> <p><a href="DisplayRule.aspx?Rule=67:48:01:14">67:48:01:14</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Hearing waiver.</p> <p><a href="DisplayRule.aspx?Rule=67:48:01:15">67:48:01:15</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Notice to individual -- Waiver of right to intentional program violation hearing.</p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:01:01 Definitions.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:01:01"> <META NAME="Description" Content="Administrative Rules 67:48:01:01 Definitions."> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Generator content="Microsoft Word 14 (filtered)"> <style> <!-- /* Font Definitions */ @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in; margin-bottom:.0001pt; text-align:justify; font-size:12.0pt; font-family:"Times New Roman","serif";} @page WordSection1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in;} div.WordSection1 {page:WordSection1;} --> </style> </head> <body lang=EN-US> <div class=WordSection1> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>67:48:01:01.&nbsp;&nbsp;Definitions.</b> Terms used in this chapter mean:</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (1)&nbsp;&nbsp;&quot;Assets,&quot; when determining eligibility for medical services, the income and resources of those individuals required to be considered under article 67:46, including any income or resources which the individual or the individual's spouse, if applicable, is entitled to receive but does not because of some action or inaction on the part of any of the individuals listed in &#167;&nbsp;67:46:05:32.01;</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (2)&nbsp;&nbsp;&quot;IPV,&quot; intentional program violation;</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (3)&nbsp;&nbsp;&quot;Long-term care,&quot; continuing 24-hour service in a medical facility, a nursing facility, an intermediate care facility for individuals with intellectual disabilities, an assisted living facility, or an adult foster home; participation in a home and community-based service program under chapter 67:54:04 or 67:44:03; and</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (4)&nbsp;&nbsp;&quot;SSI,&quot; supplemental security income.</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 25 SDR 141, effective May 20, 1999; 40 SDR 122, effective January 8, 2014.</p> <p class=MsoNormal>&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(4).</A></p> <p class=MsoNormal>&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(4).</A></p> <p class=MsoNormal>&nbsp;</p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:01:02 Establishing claim against individual -- Medical benefits paid in error.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:01:02"> <META NAME="Description" Content="Administrative Rules 67:48:01:02 Establishing claim against individual -- Medical benefits paid in error."> <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>67:48:01:02.&nbsp;&nbsp;Establishing claim against individual -- Medical benefits paid in error.</b> If medical assistance is paid on behalf of an individual and the department subsequently finds that the individual was ineligible for the medical assistance benefits paid, the department considers that the medical benefit was paid in error. A benefit paid in error constitutes a debt to and is subject to recovery from the individual by the department according to the provisions and limits of this chapter.</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> 25 SDR 141, effective May 20, 1999.</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(4).</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(4).</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> <p><font size=2 face=Times>f&#10794;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:01:03 Medical benefit not subject to recovery if error made by department.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:01:03"> <META NAME="Description" Content="Administrative Rules 67:48:01:03 Medical benefit not subject to recovery if error made by department."> <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>67:48:01:03.&nbsp;&nbsp;Medical benefit not subject to recovery if error made by department.</b> If a medical benefit is paid in error because of a mistake made by the department, the medical benefit paid in error is not subject to recovery. Instances of department error include items such as the following:</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; (1)&nbsp;&nbsp;The department failed to take prompt action on a change reported by the individual or the individual's authorized representative;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (2)&nbsp;&nbsp;The department incorrectly computed the individual's income, resources, or deductions; or</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (3)&nbsp;&nbsp;The department continued to provide the individual with medical benefits during the time the department was redetermining the individual's eligibility.</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> 25 SDR 141, effective May 20, 1999.</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(4).</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(4).</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:01:04 Recovery for certain long-term care cases.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:01:04"> <META NAME="Description" Content="Administrative Rules 67:48:01:04 Recovery for certain long-term care cases."> <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>67:48:01:04.&nbsp;&nbsp;Recovery for certain long-term care cases.</b> A medical benefit paid in error on behalf of an individual who was residing or is residing in a long-term care facility is subject to recovery from the individual if the individual meets one of the following conditions:</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; (1)&nbsp;&nbsp;The individual is not an SSI recipient and would have been ineligible for medical benefits if information concerning the individual's assets had been disclosed within the mandatory reporting period specified in §&nbsp;67:46:02:09; or</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; (2)&nbsp;&nbsp;The individual is not an SSI recipient and would have been ineligible for medical benefits if information concerning transferred assets had been disclosed within the mandatory reporting period specified in §&nbsp;67:46:02:09.</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> 25 SDR 141, effective May 20, 1999.</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(4).</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(4).</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:01:05 Medical benefit paid in error as result of intentional program violation.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:01:05"> <META NAME="Description" Content="Administrative Rules 67:48:01:05 Medical benefit paid in error as result of intentional program violation."> <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>67:48:01:05.&nbsp;&nbsp;Medical benefit paid in error as result of intentional program violation.</b> A medical benefit paid in error includes a payment made as a result of an intentional program violation. An intentional program violation exists if an administrative hearing or a court of appropriate jurisdiction finds that the individual or the individual's authorized representative intentionally made a false or misleading statement or misrepresented, concealed, or withheld facts or intentionally acted to mislead, misrepresent, conceal withhold facts, or propound a falsity for the purpose of establishing or maintaining eligibility under article 67:46 or increasing or preventing a reduction in the amount of medical benefits payable on behalf of the individual. The individual or the individual's authorized representative may sign a waiver waiving the individual's rights to an administrative hearing.</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> 25 SDR 141, effective May 20, 1999.</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(4).</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(4).</A></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>Cross-Reference:</b> Hearing waiver, §&nbsp;67:48:01:14.</font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:01:06 Administrative hearing to determine whether intentional program violation occurred.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:01:06"> <META NAME="Description" Content="Administrative Rules 67:48:01:06 Administrative hearing to determine whether intentional program violation occurred."> <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>67:48:01:06.&nbsp;&nbsp;Administrative hearing to determine whether intentional program violation occurred.</b> If the individual suspected of having committed an IPV chooses not to sign a waiver, the department shall hold an administrative hearing to determine whether an IPV occurred. An IPV hearing is held according to the provisions of SDCL chapter <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=1-26">1-26</A> and ARSD chapter 67:17:02, unless otherwise specified in this chapter.</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 hearing examiner shall base the determination of an intentional program violation on clear and convincing evidence that demonstrates that the individual committed and intended to commit an intentional program violation.</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> 25 SDR 141, effective May 20, 1999.</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(4).</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(4).</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:01:07 Notice to individual suspected of committing an intentional program violation.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:01:07"> <META NAME="Description" Content="Administrative Rules 67:48:01:07 Notice to individual suspected of committing an intentional program violation."> <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>67:48:01:07.&nbsp;&nbsp;Notice to individual suspected of committing an intentional program violation.</b> If the department intends to proceed with an IPV hearing, the department shall send a written notice to the individual suspected of having committed the intentional program violation. A copy of the notice must also be sent to the individual's authorized representative, if the department is aware that one exists. The notice must contain the following information:</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; (1)&nbsp;&nbsp;A statement that a review of the case indicates that an intentional program violation has occurred;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (2)&nbsp;&nbsp;A summary of the evidence supporting the finding;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (3)&nbsp;&nbsp;Information on how and where the evidence may be examined;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (4)&nbsp;&nbsp;Information on the intentional program violation hearing that will be scheduled; and</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (5)&nbsp;&nbsp;Instructions on how the individual may waive the right to an administrative hearing and information on the ramifications of signing the waiver.</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> 25 SDR 141, effective May 20, 1999.</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(4).</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(4).</A></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>Cross Reference:</b> Notice to individual -- Waiver of right to intentional program violation hearing, §&nbsp;67:48:01:15.</font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:01:08 Notice of intentional program violation hearing.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:01:08"> <META NAME="Description" Content="Administrative Rules 67:48:01:08 Notice of intentional program violation hearing."> <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>67:48:01:08.&nbsp;&nbsp;Notice of intentional program violation hearing.</b> If the individual chooses not to sign the IPV waiver, the department shall schedule an IPV hearing. At least 30 days before the date of the hearing, the department shall send written notice to the individual and the individual's representative, if applicable, advising the individual that an intentional program violation hearing has been scheduled. The notice must be sent by certified mail with a return receipt requested. If the notice is returned as undeliverable, the hearing may still be held. The notice must contain the following information:</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; (1)&nbsp;&nbsp;The date, time, and place of the hearing;</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; (2)&nbsp;&nbsp;The charge against the individual;</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; (3)&nbsp;&nbsp;A summary of the evidence;</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; (4)&nbsp;&nbsp;Information on how and where the evidence may be examined;</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; (5)&nbsp;&nbsp;A warning that the decision will be based solely on information provided by the department if the individual or the individual's representative, if applicable, fails to appear at the hearing;</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; (6)&nbsp;&nbsp;A statement that the individual or the individual's representative, if applicable, has 10 days from the date of the scheduled hearing to present good cause for failing to appear in order to receive a new hearing;</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; (7)&nbsp;&nbsp;A statement that the hearing does not preclude the state or federal government from prosecuting the individual for the intentional program violation in a civil or criminal court action or from collecting any overpayment; and</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; (8)&nbsp;&nbsp;The name of the individual or organization that provides free legal representation.</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> 25 SDR 141, effective May 20, 1999.</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(4).</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(4).</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:01:09 Individual's rights -- Intentional program violation hearing.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:01:09"> <META NAME="Description" Content="Administrative Rules 67:48:01:09 Individual's rights -- Intentional program violation hearing."> <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>67:48:01:09.&nbsp;&nbsp;Individual's rights -- Intentional program violation hearing.</b> If the department holds an IPV hearing, the department shall give the individual or the individual's representative, if applicable, the opportunity to:</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; (1)&nbsp;&nbsp;Examine the documents and records to be used at the hearing at a reasonable time before the date of the hearing as well as during the hearing;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (2)&nbsp;&nbsp;Present the case or have it presented by legal counsel or another person;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (3)&nbsp;&nbsp;Bring witnesses;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (4)&nbsp;&nbsp;Advance arguments;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (5)&nbsp;&nbsp;Question or refute any testimony or evidence, including an opportunity to confront and cross-examine adverse witnesses; and</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (6)&nbsp;&nbsp;Submit evidence to establish pertinent facts and circumstances in the case.</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> 25 SDR 141, effective May 20, 1999.</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(4).</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(4).</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:01:10 Time frame for holding hearing and writing final decision.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:01:10"> <META NAME="Description" Content="Administrative Rules 67:48:01:10 Time frame for holding hearing and writing final decision."> <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>67:48:01:10.&nbsp;&nbsp;Time frame for holding hearing and writing final decision.</b> A hearing examiner shall conduct the hearing, arrive at a decision, and notify the individual and the department of the final hearing decision within 90 days of the date the individual was notified in writing that the IPV hearing was scheduled.</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> 25 SDR 141, effective May 20, 1999.</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(4).</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(4).</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:01:11 Postponement of intentional program violation hearing.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:01:11"> <META NAME="Description" Content="Administrative Rules 67:48:01:11 Postponement of intentional program violation hearing."> <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>67:48:01:11.&nbsp;&nbsp;Postponement of intentional program violation hearing.</b> The individual may request that the IPV hearing be postponed. The request must be made at least 10 days before the date of the scheduled hearing. The hearing may not be postponed for more than 30 days and the number of postponements is limited to one. If the hearing is postponed, the department shall extend the 90-day time limit established in §&nbsp;67:48:01:10 for as many days as the hearing is postponed.</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> 25 SDR 141, effective May 20, 1999.</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(4).</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(4).</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:01:12 Hearing may be held in absence of accused individual -- Department to conduct new hearing if good cause found for individual's absence.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:01:12"> <META NAME="Description" Content="Administrative Rules 67:48:01:12 Hearing may be held in absence of accused individual -- Department to conduct new hearing if good cause found for individual's absence."> <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>67:48:01:12.&nbsp;&nbsp;Hearing may be held in absence of accused individual -- Department to conduct new hearing if good cause found for individual's absence.</b> If the individual cannot be located or fails to appear at an IPV hearing without good cause, the hearing examiner shall conduct the hearing without the individual being represented. The hearing examiner shall consider the evidence to determine whether an intentional program violation was committed. If the individual is found to have committed an intentional program violation but a hearing examiner later determines that the individual had good cause for not appearing, the previous decision is no longer valid and the department shall conduct a new hearing. The hearing examiner who originally rules on the case may conduct the new hearing.</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; In instances where good cause for failure to appear is based on a showing of nonreceipt of the hearing notice, the individual has 30 days after the date of the written notice of the hearing decision to claim good cause. In all other instances, the individual has 10 days from the date of the scheduled hearing to present reasons for failing to appear. The hearing examiner shall enter the good cause decision into the record.</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> 25 SDR 141, effective May 20, 1999.</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(4).</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(4).</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:01:13 Consolidation of hearings.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:01:13"> <META NAME="Description" Content="Administrative Rules 67:48:01:13 Consolidation of hearings."> <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>67:48:01:13.&nbsp;&nbsp;Consolidation of hearings.</b> The department may combine a fair hearing and an IPV hearing into a single hearing if the factual issues arise out of the same or related circumstances and the individual receives prior notice that the hearings will be combined. If the hearings are combined, the department shall follow the time frames for conducting an intentional program violation hearing. However, at the individual's request, the department shall waive the 30-day advance notice period required.</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; If the hearings are combined for the purpose of settling the amount of the overpayment at the same time as determining whether or not an intentional program violation has occurred, the individual loses the right to a subsequent fair hearing on the amount of the claim.</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> 25 SDR 141, effective May 20, 1999.</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(4).</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(4).</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:01:14 Hearing waiver.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:01:14"> <META NAME="Description" Content="Administrative Rules 67:48:01:14 Hearing waiver."> <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>67:48:01:14.&nbsp;&nbsp;Hearing waiver.</b> An individual accused of committing an intentional program violation may waive the right to an administrative hearing. If the individual waives this right, the department may initiate a collection action against the individual to recover the amount of the overpayment.</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> 25 SDR 141, effective May 20, 1999.</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(4).</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(4).</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:01:15 Notice to individual -- Waiver of right to intentional program violation hearing.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:01:15"> <META NAME="Description" Content="Administrative Rules 67:48:01:15 Notice to individual -- Waiver of right to intentional program violation hearing."> <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>67:48:01:15.&nbsp;&nbsp;Notice to individual -- Waiver of right to intentional program violation hearing.</b> The department shall provide written notice to the individual suspected of having committed an intentional program violation that the individual may waive the right to an IPV hearing. The notice must include at least the following information:</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; (1)&nbsp;&nbsp;The date the department must receive the signed waiver to avoid the holding of an intentional program violation hearing;</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; (2)&nbsp;&nbsp;A signature block for the accused individual or the individual's authorized representative, if applicable, to sign;</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; (3)&nbsp;&nbsp;A statement of the accused individual's right to remain silent concerning the charge and that anything said or signed by the individual concerning the charge may be used against the individual in a court of law; and</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; (4)&nbsp;&nbsp;An opportunity for the accused individual to specify whether or not the individual admits to the facts as presented by the department.</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> 25 SDR 141, effective May 20, 1999.</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(4).</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(4).</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <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"> <title>Rule 67:48:02 LIENS AND ESTATE RECOVERIES</title> <META NAME="Keywords" Content="Administrative Rules 67:48:02"> <META NAME="Description" Content="Administrative Rules 67:48:02 LIENS AND ESTATE RECOVERIES"> <style> <!-- --> </style> </head> <body lang=EN-US> <div> <h1><b>CHAPTER 67:48:02</b></h1> <p align=center><b>LIENS AND ESTATE RECOVERIES</b></p> <p>Section</p> <p><a href="DisplayRule.aspx?Rule=67:48:02:01">67:48:02:01</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Definitions.</p> <p><a href="DisplayRule.aspx?Rule=67:48:02:02">67:48:02:02</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Individuals subject to liens and estate recoveries.</p> <p><a href="DisplayRule.aspx?Rule=67:48:02:03">67:48:02:03</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Lien filed for medical assistance.</p> <p><a href="DisplayRule.aspx?Rule=67:48:02:04">67:48:02:04</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Lien on home prohibited under certain circumstances.</p> <p><a href="DisplayRule.aspx?Rule=67:48:02:05">67:48:02:05</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Recovery against an individual's estate.</p> <p><a href="DisplayRule.aspx?Rule=67:48:02:06">67:48:02:06</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Recovery when individual would have been ineligible for assistance.</p> <p><a href="DisplayRule.aspx?Rule=67:48:02:07">67:48:02:07</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Fair hearing.</p> <p><a href="DisplayRule.aspx?Rule=67:48:02:08">67:48:02:08</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Recovery against estate of surviving spouse -- Petition to limit financial responsibility -- Determination of value of estate.</p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:02:01 Definitions.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:02:01"> <META NAME="Description" Content="Administrative Rules 67:48:02:01 Definitions."> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Generator content="Microsoft Word 14 (filtered)"> <style> <!-- /* Font Definitions */ @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in; margin-bottom:.0001pt; text-align:justify; font-size:12.0pt; font-family:"Times New Roman","serif";} @page WordSection1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in;} div.WordSection1 {page:WordSection1;} --> </style> </head> <body lang=EN-US> <div class=WordSection1> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>67:48:02:01.&nbsp;&nbsp;Definitions.</b> Terms used in this chapter mean:</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (1)&nbsp;&nbsp;&quot;Contiguous property,&quot; all land adjacent to the home including land separated only by roads, rivers, streams, and similar features and not separated by intervening property owned by another person;</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (2)&nbsp;&nbsp;&quot;Estate,&quot; all real and personal property and other assets included within the individual's estate as defined in SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=29A-1-201">29A-1-201</A>, and any other real and personal property or other assets in which the individual had any legal title or interest at the time of death, including such assets conveyed to a survivor, heir, or assign of the deceased individual through joint tenancy, tenancy in common, survivorship, life estate, living trust, or other arrangement, including any funds remaining in an individual's prepaid burial trust or prepaid burial account after the individual's reasonable burial expenses are paid; and</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (3)&nbsp;&nbsp;&quot;Real property,&quot; real property as defined in SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=43-1-3">43-1-3.</A></p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 21 SDR 119, effective January 4, 1995; 40 SDR 229, effective June 30, 2014.</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-23">28-6-23</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-24">28-6-24.</A></p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Law Implemented:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-23">28-6-23</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-24">28-6-24.</A></p> <p class=MsoNormal>&nbsp;</p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:02:02 Individuals subject to liens and estate recoveries.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:02:02"> <META NAME="Description" Content="Administrative Rules 67:48:02:02 Individuals subject to liens and estate recoveries."> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Generator content="Microsoft Word 14 (filtered)"> <style> <!-- /* Font Definitions */ @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in; margin-bottom:.0001pt; text-align:justify; font-size:12.0pt; font-family:"Times New Roman","serif";} @page WordSection1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in;} div.WordSection1 {page:WordSection1;} --> </style> </head> <body lang=EN-US> <div class=WordSection1> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>67:48:02:02.&nbsp;&nbsp;Individuals subject to liens and estate recoveries.</b> Any payment of medical assistance by or through the department is a debt due to the department if the individual is residing in any of the following:</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (1)&nbsp;&nbsp;A nursing home;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (2)&nbsp;&nbsp;An intermediate care facility for individuals with intellectual disabilities;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (3)&nbsp;&nbsp;An adult foster care home;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (4)&nbsp;&nbsp;An assisted living center;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (5)&nbsp;&nbsp;A hospital swingbed; or</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (6)&nbsp;&nbsp;An institution for individuals with a mental disease.</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 21 SDR 119, effective January 4, 1995; 40 SDR 122, effective January 8, 2014.</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-23">28-6-23</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-24">28-6-24.</A></p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Law Implemented:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-23">28-6-23</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-24">28-6-24.</A></p> <p class=MsoNormal>&nbsp;</p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:02:03 Lien filed for medical assistance.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:02:03"> <META NAME="Description" Content="Administrative Rules 67:48:02:03 Lien filed for medical assistance."> <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>67:48:02:03.&nbsp;&nbsp;Lien filed for medical assistance.</b> A lien created under the provisions of SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-24">28-6-24</A> may be filed against an individual's home and other real property in which the individual has a legal interest.</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; Real property includes home property, real property held in trust, and other real property.</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; Home property is the shelter which the individual owns and which is used by the individual as the individual's principal place of residence. Home property includes the buildings and contiguous property.</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; Real property held in trust is that property to which the federal government has the legal title but which is being held for the benefit of citizens.</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; Other real property is any real property other than that having the characteristics of home property or real property held in trust. Other real property includes property owned by the individual but separated from the individual's home property by property belonging to another.</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 amount of the lien is the amount of the medical assistance provided by the department on behalf of the individual after June 30, 1994. The lien is limited to the cost of those services specified in SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-23">28-6-23.</A></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> 21 SDR 119, effective January 4, 1995.</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=28-6-23">28-6-23</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-24">28-6-24.</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=28-6-23">28-6-23</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-24">28-6-24.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:02:04 Lien on home prohibited under certain circumstances.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:02:04"> <META NAME="Description" Content="Administrative Rules 67:48:02:04 Lien on home prohibited under certain circumstances."> <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>67:48:02:04.&nbsp;&nbsp;Lien on home prohibited under certain circumstances.</b> The department may not place a lien on an individual's home if there is a reasonable expectation, based on the individual's medical, nursing, and social needs, that the individual will return home or if any of the following persons are lawfully residing in the home:</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; (1)&nbsp;&nbsp;The individual's spouse;</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; (2)&nbsp;&nbsp;The individual's adult child if the adult child has resided in and used the home as his principal place of residence for a continuous period of at least two years immediately prior to the date the individual was admitted to any of the facilities listed in SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-24">28-6-24</A> and can establish to the department that the adult child had been providing care which permitted the individual to reside at home rather than in an institution;</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; (3)&nbsp;&nbsp;The individual's child who is under age 21 or is blind or disabled;</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; (4)&nbsp;&nbsp;The individual's sibling who has an equity interest in the home and who has resided in and used the home as his principal place of residence for a continuous period of at least one year immediately prior to the date the individual was admitted to any of the facilities listed in SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-24">28-6-24.</A></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; A person is considered to be lawfully residing in the home if the person is residing in the home with the permission of the owner or, if the owner is under guardianship or conservatorship, with the permission of the guardian or conservator.</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> 21 SDR 119, effective January 4, 1995.</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=28-6-23">28-6-23</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-24">28-6-24.</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=28-6-23">28-6-23</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-24">28-6-24.</A></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>Cross-References:</b> Determination of disability, §&nbsp;67:46:03:18; Determination of blindness, §&nbsp;67:46:03:19.</font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html xmlns:v="urn:schemas-microsoft-com:vml" xmlns:o="urn:schemas-microsoft-com:office:office" xmlns:w="urn:schemas-microsoft-com:office:word" xmlns="http://www.w3.org/TR/REC-html40"> <head> <title>Rule 67:48:02:05 Recovery against an individual's estate.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:02:05"> <META NAME="Description" Content="Administrative Rules 67:48:02:05 Recovery against an individual's estate."> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=ProgId content=Word.Document> <meta name=Generator content="Microsoft Word 10"> <meta name=Originator content="Microsoft Word 10"> <link rel=File-List href="6748020000500d_files/filelist.xml"> <!--[if gte mso 9]><xml> <o:DocumentProperties> <o:Author>lrpr14533</o:Author> <o:LastAuthor>lrpr14296</o:LastAuthor> <o:Revision>2</o:Revision> <o:TotalTime>2</o:TotalTime> <o:Created>2007-12-26T14:31:00Z</o:Created> <o:LastSaved>2007-12-26T14:31:00Z</o:LastSaved> <o:Pages>1</o:Pages> <o:Words>203</o:Words> <o:Characters>1163</o:Characters> <o:Company>State of South Dakota</o:Company> <o:Lines>9</o:Lines> <o:Paragraphs>2</o:Paragraphs> <o:CharactersWithSpaces>1364</o:CharactersWithSpaces> <o:Version>10.6830</o:Version> </o:DocumentProperties> </xml><![endif]--><!--[if gte mso 9]><xml> <w:WordDocument> <w:GrammarState>Clean</w:GrammarState> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--> <style> <!-- /* Font Definitions */ @font-face {font-family:Times; panose-1:2 2 6 3 5 4 5 2 3 4; mso-font-charset:0; mso-generic-font-family:roman; mso-font-format:other; mso-font-pitch:variable; mso-font-signature:3 0 0 0 1 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:""; margin:0in; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:Times; mso-fareast-font-family:"Times New Roman"; mso-bidi-font-family:"Times New Roman";} span.GramE {mso-style-name:""; mso-gram-e:yes;} @page Section1 {size:8.5in 11.0in; margin:1.0in 1.25in 1.0in 1.25in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.Section1 {page:Section1;} --> </style> <!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman";} </style> <![endif]--><!--[if gte mso 9]><xml> <o:shapedefaults v:ext="edit" spidmax="1026"/> </xml><![endif]--><!--[if gte mso 9]><xml> <o:shapelayout v:ext="edit"> <o:idmap v:ext="edit" data="1"/> </o:shapelayout></xml><![endif]--> </head> <body lang=EN-US style='tab-interval:.5in'> <div class=Section1> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><span style='mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><b style='mso-bidi-font-weight:normal'>67:48:02:05.<span class=GramE>&nbsp;&nbsp;Recovery</span> against an individual's estate.</b> If the department provided any of the services specified in SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-23">28-6-23</A>, and the individual has since died, the department shall seek to recover from the individual's estate the benefits paid on behalf of the individual.<o:p></o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><span style='mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>If the individual had a long-term care partnership insurance policy that paid for services, the department shall reduce the amount of recovery from the individual's estate by the amount of the assets disregarded at the time Medicaid eligibility was determined less the amount of disregarded assets disposed of before the individual's death. The benefits paid by insurance must be from a long-term care partnership policy approved by the Division of Insurance. In no case may the amount of the reduction exceed the amount paid under the long-term care partnership insurance policy.<o:p></o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><span style='mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>The department may not seek recovery from the individual's estate if the individual's spouse is still living or if the individual has a surviving child who is under age 21 or is blind or disabled.<o:p></o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><span style='mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><b style='mso-bidi-font-weight:normal'>Source:</b> 21 SDR 119, effective January 4, 1995; 34 SDR 180, effective December 26, 2007.<o:p></o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><span style='mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><b style='mso-bidi-font-weight:normal'>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-23">28-6-23.</A><o:p></o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><span style='mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><b style='mso-bidi-font-weight:normal'>Law Implemented:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-23">28-6-23.</A><o:p></o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><span style='mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><b style='mso-bidi-font-weight:normal'>Cross-References:<o:p></o:p></b></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><b style='mso-bidi-font-weight:normal'><span style='font-size:12.0pt;mso-bidi-font-size: 10.0pt;font-family:"Times New Roman"'><span style='mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></b><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'>Determination of disability, &#167;&nbsp;67:46:03:18.<o:p></o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><span style='mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>Determination of blindness, &#167;&nbsp;67:46:03:19.<o:p></o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><span style='mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>Long-term care insurance, ch 20:06:21.<o:p></o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><o:p>&nbsp;</o:p></span></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:02:06 Recovery when individual would have been ineligible for assistance.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:02:06"> <META NAME="Description" Content="Administrative Rules 67:48:02:06 Recovery when individual would have been ineligible for assistance."> <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>67:48:02:06.&nbsp;&nbsp;Recovery when individual would have been ineligible for assistance.</b> If the department finds that the individual owned property or other assets which would have made the individual ineligible for medical assistance, the department shall seek to recover the amount of benefits paid and the prohibitions for the placement of liens and the recovery from estates contained in §§&nbsp;67:48:02:04 and 67:48:02:05 do not apply.</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> 21 SDR 119, effective January 4, 1995.</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=28-6-23">28-6-23</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-24">28-6-24.</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=28-6-23">28-6-23</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-24">28-6-24.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:02:07 Fair hearing.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:02:07"> <META NAME="Description" Content="Administrative Rules 67:48:02:07 Fair hearing."> <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>67:48:02:07.&nbsp;&nbsp;Fair hearing.</b> A surviving spouse who is dissatisfied with the determination made under §&nbsp;67:48:02:08 may request a fair hearing.</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; If a fair hearing is requested because of the imposition of a lien, the only issue which may be raised at the hearing is whether the requirements for the imposition of the lien have been met. Fair hearings are conducted under the provisions of chapter 67:17:02.</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> 21 SDR 119, effective January 4, 1995; 24 SDR 19, effective August 21, 1997.</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=28-6-23">28-6-23</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-24">28-6-24.</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=1-26-16">1-26-16</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-23">28-6-23</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-24">28-6-24.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:02:08 Recovery against estate of surviving spouse -- Petition to limit financial responsibility -- Determination of value of estate.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:02:08"> <META NAME="Description" Content="Administrative Rules 67:48:02:08 Recovery against estate of surviving spouse -- Petition to limit financial responsibility -- Determination of value of estate."> <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>67:48:02:08.&nbsp;&nbsp;Recovery against estate of surviving spouse -- Petition to limit financial responsibility -- Determination of value of estate.</b> For purposes of SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-23.1">28-6-23.1</A>, the surviving spouse must petition the department on a form available from the department. The surviving spouse or the surviving spouse's authorized representative or legal guardian must complete, sign, and return the form to the department.</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; If a medical recipient's death occurred after June 30, 1994, but before July 1, 1997, the department shall consider a petition to limit the financial responsibility of the estate of a surviving spouse if the petition is submitted and received by the department by January 1, 1998.</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 department shall use the completed form and §§&nbsp;67:46:05:08 and 67:46:05:36 to determine the amount of the surviving spouse's resources which are available for recovery.</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; For purposes of this rule, the fair market value of property is determined by using 100 percent of the county's tax valuation for the property.</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> 24 SDR 19, effective August 21, 1997.</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=28-6-23">28-6-23.</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=28-6-23">28-6-23.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <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"> <title>Rule 67:48:03 RECOVERIES FROM PROVIDERS</title> <META NAME="Keywords" Content="Administrative Rules 67:48:03"> <META NAME="Description" Content="Administrative Rules 67:48:03 RECOVERIES FROM PROVIDERS"> <style> <!-- --> </style> </head> <body lang=EN-US> <div> <p align=center><b>CHAPTER 67:48:03</b></p> <p align=center><b>&nbsp;</b></p> <p align=center><b>RECOVERIES FROM PROVIDERS</b></p> <p>Section</p> <p><a href="DisplayRule.aspx?Rule=67:48:03:01">67:48:03:01</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Reserved.</p> <p><a href="DisplayRule.aspx?Rule=67:48:03:02">67:48:03:02</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Provider to reimburse department for services paid by both the department and another payment source -- Time limit for reimbursing department.</p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:03:01 Reserved.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:03:01"> <META NAME="Description" Content="Administrative Rules 67:48:03:01 Reserved."> <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>67:48:03:01.&nbsp;&nbsp;Reserved.</b></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:03:02 Provider to reimburse department for services paid by both the department and another payment source -- Time limit for reimbursing department.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:03:02"> <META NAME="Description" Content="Administrative Rules 67:48:03:02 Provider to reimburse department for services paid by both the department and another payment source -- Time limit for reimbursing department."> <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>67:48:03:02.&nbsp;&nbsp;Provider to reimburse department for services paid by both the department and another payment source -- Time limit for reimbursing department.</b> If the department pays a provider for services provided on behalf of a Medicaid recipient and the provider has received or subsequently receives payment for the same service from a source other than the Medicaid recipient or the county, the provider must reimburse the department. The provider must reimburse the department within 45 days after receiving payment from the other source. If the payment is for a service provided within the last 12 months, the provider's reimbursement must be accomplished by submitting an adjustment/void claim form to the department. Failure to reimburse the department within the time limit shall result in an action against the provider to recover the payment.</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> 26 SDR 162, effective June 14, 2000.</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> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Cross-Reference:</b> Claims, ch 67:16:35.</font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <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"> <title>Rule 67:48:04 RECOVERIES FROM POLICYHOLDERS</title> <META NAME="Keywords" Content="Administrative Rules 67:48:04"> <META NAME="Description" Content="Administrative Rules 67:48:04 RECOVERIES FROM POLICYHOLDERS"> <style> <!-- --> </style> </head> <body lang=EN-US> <div> <p align=center><b>CHAPTER 67:48:04</b></p> <p align=center><b>&nbsp;</b></p> <p align=center><b>RECOVERIES FROM POLICYHOLDERS</b></p> <p>Section</p> <p><a href="DisplayRule.aspx?Rule=67:48:04:01">67:48:04:01</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Reserved.</p> <p><a href="DisplayRule.aspx?Rule=67:48:04:02">67:48:04:02</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Policyholder to reimburse department for services paid by both Medicaid and insurance -- Time limit for reimbursing department.</p> <p><a href="DisplayRule.aspx?Rule=67:48:04:03">67:48:04:03</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Limit on attorney fees.</p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:04:01 Reserved.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:04:01"> <META NAME="Description" Content="Administrative Rules 67:48:04:01 Reserved."> <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>67:48:04:01.&nbsp;&nbsp;Reserved.</b></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:04:02 Policyholder to reimburse department for services paid by both Medicaid and insurance -- Time limit for reimbursing department.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:04:02"> <META NAME="Description" Content="Administrative Rules 67:48:04:02 Policyholder to reimburse department for services paid by both Medicaid and insurance -- Time limit for reimbursing department."> <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>67:48:04:02.&nbsp;&nbsp;Policyholder to reimburse department for services paid by both Medicaid and insurance -- Time limit for reimbursing department.</b> A policyholder must reimburse the department if the policyholder receives reimbursement from the policyholder's insurance company for medical services paid by the department on behalf of an individual who is Medicaid-eligible and covered under the policyholder's insurance. The policyholder must reimburse the department within 45 days after receiving the payment from the insurance company. Failure to reimburse the department within the time limit shall result in an action against the policyholder to recover the payment.</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> 26 SDR 162, effective June 14, 2000.</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> <br /><hr><br /><html> <head> <title>Rule 67:48:04:03 Limit on attorney fees.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:04:03"> <META NAME="Description" Content="Administrative Rules 67:48:04:03 Limit on attorney fees."> <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>67:48:04:03.&nbsp;&nbsp;Limit on attorney fees.</b> For purposes of SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-7.1">28-6-7.1</A>, attorney fees payable by the department are limited to the following:</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; (1)&nbsp;&nbsp;If the department has agreed to the terms of a settlement which the individual's attorney has negotiated, 25 percent of the settlement that relates to the Medicaid expenditures recovered;</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; (2)&nbsp;&nbsp;If the amount of the award is determined through a third-party mediation, an administrative hearing, or by a circuit court, 33&nbsp;1/3 percent of the award that relates to the Medicaid expenditures recovered;</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; (3)&nbsp;&nbsp;If the amount of the award determined under subdivision (2) is appealed to and successful in a higher court, 40 percent of the award that relates to the Medicaid expenditures recovered;</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; (4)&nbsp;&nbsp;If the third-party mediation, administrative hearing, or court action referred to in subdivision (2) or (3) of this section is for the purpose of either reducing the amount of the award payable to the department or increasing the attorney fees payable by the department, 25 percent of the original award that relates to the Medicaid expenditures recovered; or</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; (5)&nbsp;&nbsp;If the award includes a workers' compensation claim, the limits established in SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=62-7-36">62-7-36.</A></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; When the attorney acting on behalf of the individual receives the award, the attorney shall immediately deduct the applicable fee from the Medicaid expenditures recovered and send the remainder to the department. The attorney must deduct the fee in one lump sum and may not deduct amounts that represent taxes on the attorney fees.</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; Nothing in this section prohibits the department from negotiating with the individual's attorney for a rate lower than the fees specified in this section.</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> 26 SDR 162, effective June 14, 2000.</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=28-6-7.1">28-6-7.1.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <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"> <title>Rule 67:48:05 RECOVERIES -- CHILD CARE SERVICES</title> <META NAME="Keywords" Content="Administrative Rules 67:48:05"> <META NAME="Description" Content="Administrative Rules 67:48:05 RECOVERIES -- CHILD CARE SERVICES"> <style> <!-- --> </style> </head> <body lang=EN-US> <div> <p align=center><b>CHAPTER 67:48:05</b></p> <p align=center><b>&nbsp;</b></p> <h1><b>RECOVERIES -- CHILD CARE SERVICES</b></h1> <p>Section</p> <p><a href="DisplayRule.aspx?Rule=67:48:05:01">67:48:05:01</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Definitions.</p> <p><a href="DisplayRule.aspx?Rule=67:48:05:02">67:48:05:02</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Recovery of overpayments -- Funds paid in error.</p> <p><a href="DisplayRule.aspx?Rule=67:48:05:03">67:48:05:03</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Benefit paid in error as a result of intentional program violation.</p> <p><a href="DisplayRule.aspx?Rule=67:48:05:04">67:48:05:04</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Intentional program violation disqualification hearing.</p> <p><a href="DisplayRule.aspx?Rule=67:48:05:05">67:48:05:05</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Hearing waiver.</p> <p><a href="DisplayRule.aspx?Rule=67:48:05:06">67:48:05:06</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Notice of hearing.</p> <p><a href="DisplayRule.aspx?Rule=67:48:05:07">67:48:05:07</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Individual's rights -- Administrative disqualification hearing.</p> <p><a href="DisplayRule.aspx?Rule=67:48:05:08">67:48:05:08</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Hearing may be held in absence of accused individual -- Department to conduct new hearing if good cause found for individual's absence.</p> <p><a href="DisplayRule.aspx?Rule=67:48:05:09">67:48:05:09</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Postponement of IPV hearing.</p> <p><a href="DisplayRule.aspx?Rule=67:48:05:10">67:48:05:10</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Disqualification hearing decision.</p> <p><a href="DisplayRule.aspx?Rule=67:48:05:11">67:48:05:11</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Disqualification -- Notice -- Penalties.</p> <p><a href="DisplayRule.aspx?Rule=67:48:05:12">67:48:05:12</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Consolidation of administrative disqualification hearing with fair hearing.</p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:05:01 Definitions.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:05:01"> <META NAME="Description" Content="Administrative Rules 67:48:05:01 Definitions."> <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>67:48:05:01.&nbsp;&nbsp;Definitions.</b> Terms used in this chapter mean:</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; (1)&nbsp;&nbsp;&quot;Child care assistance&quot; or &quot;child care services,&quot; payments made by the department to a child care provider for caring for the child of an individual who qualifies to receive assistance with the payment of child care costs under the provisions of chapters 67:47:01 to 67:47:03, inclusive; or payments made by the department to a child care provider under the terms of a grant obtained under the provisions of chapter 67:47:04;</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; (2)&nbsp;&nbsp;&quot;IPV,&quot; intentional program violation; and</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; (3)&nbsp;&nbsp;&quot;Provider,&quot; a child care provider who receives child care assistance payments or grant funds from the department under the provisions of article 67:47.</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> 28 SDR 111, effective February 20, 2002.</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=28-1-61">28-1-61.</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=28-1-61">28-1-61.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:05:02 Recovery of overpayments -- Funds paid in error.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:05:02"> <META NAME="Description" Content="Administrative Rules 67:48:05:02 Recovery of overpayments -- Funds paid in error."> <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>67:48:05:02.&nbsp;&nbsp;Recovery of overpayments -- Funds paid in error.</b> The department shall consider that funds were paid in error if any of the following occurs:</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; (1)&nbsp;&nbsp;The department pays the provider for child care services and subsequently finds that the individual on whose behalf the funds were paid was ineligible for child care assistance;</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; (2)&nbsp;&nbsp;The department pays the provider for child care services on behalf of an individual who was eligible for child care assistance but the department subsequently finds that the amount of assistance paid exceeded the amount of benefits payable;</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; (3)&nbsp;&nbsp;The department pays the provider for child care services and subsequently finds that the provider was not entitled to the benefits; or</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; (4)&nbsp;&nbsp;The department pays child care services grant funds to a provider and the provider fails to fulfill the requirements of the grant.</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; Child care assistance paid in error as a result of an intentional program violation constitutes a debt to and is subject to recovery by the department according to the provisions and limits of this chapter. Child care assistance paid in error that is not the result of an intentional program violation constitutes a debt to and is subject to recovery by the department according to the provisions and limits of article 67:47.</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> 28 SDR 111, effective February 20, 2002.</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=28-1-61">28-1-61.</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=28-1-61">28-1-61.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:05:03 Benefit paid in error as a result of intentional program violation.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:05:03"> <META NAME="Description" Content="Administrative Rules 67:48:05:03 Benefit paid in error as a result of intentional program violation."> <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>67:48:05:03.&nbsp;&nbsp;Benefit paid in error as result of intentional program violation.</b> A benefit paid in error includes a payment made as a result of an intentional program violation. An IPV exists if any of the following occurs:</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; (1)&nbsp;&nbsp;The individual pleads guilty or nolo contendere to fraud;</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; (2)&nbsp;&nbsp;The individual waives the right to a disqualification hearing; or</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; (3)&nbsp;&nbsp;An administrative hearing officer or a court of appropriate jurisdiction finds that the individual made a false or misleading statement or misrepresented, concealed, or withheld facts or intentionally acted to mislead, misrepresent, conceal, withhold facts, or propound a falsity for the purpose of establishing or maintaining eligibility under article 67:48 or increasing or preventing a reduction in the amount of benefits payable.</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> 28 SDR 111, effective February 20, 2002.</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=28-1-61">28-1-61.</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=28-1-61">28-1-61.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:05:04 Intentional program violation disqualification hearing.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:05:04"> <META NAME="Description" Content="Administrative Rules 67:48:05:04 Intentional program violation disqualification hearing."> <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>67:48:05:04.&nbsp;&nbsp;Intentional program violation disqualification hearing.</b> If the department finds evidence that indicates an intentional program violation has occurred, the department may initiate an administrative disqualification hearing or may refer the matter to federal, state, or local officials for further legal 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> 28 SDR 111, effective February 20, 2002.</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=28-1-61">28-1-61.</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=28-1-61">28-1-61.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:05:05 Hearing waiver.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:05:05"> <META NAME="Description" Content="Administrative Rules 67:48:05:05 Hearing waiver."> <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>67:48:05:05.&nbsp;&nbsp;Hearing waiver.</b> An individual accused of committing an IPV may waive the right to an administrative hearing for the first or second violations. If the individual waives this right, the department may initiate a collection action against the individual to recover the amount of the overpayment.</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; If the individual suspected of having committed an IPV chooses not to sign a waiver, the department shall hold an administrative disqualification hearing to determine whether an IPV occurred.</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; An IPV hearing is held according to the provisions of SDCL chapter <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=1-26">1-26</A> and ARSD chapter 67:17:02, unless otherwise specified in this chapter.</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> 28 SDR 111, effective February 20, 2002.</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=28-1-61">28-1-61.</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=28-1-61">28-1-61.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:05:06 Notice of hearing.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:05:06"> <META NAME="Description" Content="Administrative Rules 67:48:05:06 Notice of hearing."> <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>67:48:05:06.&nbsp;&nbsp;Notice of hearing.</b> If the individual chooses not to sign the IPV waiver, the department shall schedule an IPV hearing. At least 30 days before the date of the hearing, the department shall send written notice to the individual suspected of having committed the IPV. The notice must be sent by certified mail with return receipt requested and must include the following information:</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; (1)&nbsp;&nbsp;The date, time, and location of the hearing;</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; (2)&nbsp;&nbsp;The charge against the individual;</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; (3)&nbsp;&nbsp;A summary of the evidence and a statement of how and where the individual may examine the evidence;</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; (4)&nbsp;&nbsp;A warning that the decision by the hearing officer will be based solely on information provided by the department if the individual fails to appear at the hearing;</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; (5)&nbsp;&nbsp;A statement that the individual may request a postponement of the hearing if the request is made to the department at least 10 days prior to the scheduled hearing;</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; (6)&nbsp;&nbsp;A statement that the individual has 10 days from the date of the scheduled hearing to present good cause for failing to appear at the hearing in order to receive a new hearing;</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; (7)&nbsp;&nbsp;A description of the penalties that result from a determination that the individual has committed an IPV and a statement indicating which penalty is applicable to the individual;</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; (8)&nbsp;&nbsp;A statement that the hearing does not preclude the department from prosecuting the individual for an IPV in a criminal court action or from collecting the overpayment;</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; (9)&nbsp;&nbsp;A listing of individuals or organizations that provide free legal representation to individuals alleged to have committed an IPV;</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; (10)&nbsp;&nbsp;An explanation that the individual may waive the right to appear at an administrative disqualification hearing; and</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; (11)&nbsp;&nbsp;A statement of the individual's right to remain silent concerning the charge and that anything said or signed by the individual concerning the charge may be used against the individual in a court of law.</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> 28 SDR 111, effective February 20, 2002.</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=28-1-61">28-1-61.</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=28-1-61">28-1-61.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:05:07 Individual's rights -- Administrative disqualification hearing.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:05:07"> <META NAME="Description" Content="Administrative Rules 67:48:05:07 Individual's rights -- Administrative disqualification hearing."> <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>67:48:05:07.&nbsp;&nbsp;Individual's rights -- Administrative disqualification hearing.</b> If the department notifies an individual suspected of committing an IPV that an administrative disqualification hearing is scheduled, the individual has the following rights:</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; (1)&nbsp;&nbsp;To examine the documents and records to be used at the hearing at a reasonable time before the date of the hearing as well as during the hearing;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (2)&nbsp;&nbsp;To present the case or have it presented by legal counsel or another person;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (3)&nbsp;&nbsp;To bring witnesses;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (4)&nbsp;&nbsp;To advance arguments;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (5)&nbsp;&nbsp;To question or refute any testimony or evidence, including an opportunity to confront and cross-examine witnesses; and</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (6)&nbsp;&nbsp;To submit evidence to establish pertinent facts and circumstances in the case.</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> 28 SDR 111, effective February 20, 2002.</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=28-1-61">28-1-61.</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=28-1-61">28-1-61.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:05:08 Hearing may be held in absence of accused individual -- Department to conduct new hearing if good cause found for individual's absence.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:05:08"> <META NAME="Description" Content="Administrative Rules 67:48:05:08 Hearing may be held in absence of accused individual -- Department to conduct new hearing if good cause found for individual's absence."> <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>67:48:05:08.&nbsp;&nbsp;Hearing may be held in absence of accused individual -- Department to conduct new hearing if good cause found for individual's absence.</b> If the individual cannot be located or fails to appear at an IPV hearing without good cause, the hearing examiner shall conduct the hearing without the individual being represented. The hearing examiner shall consider the evidence to determine whether an intentional program violation was committed. If the individual is found to have committed an intentional program violation but a hearing examiner later determines that the individual had good cause for not appearing, the previous decision is no longer valid and the department shall conduct a new hearing. The hearing examiner who originally ruled on the case may conduct the new hearing.</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; If good cause for failure to appear is based on a showing of nonreceipt of the hearing notice, the individual has 30 days after the date of the written notice of the hearing decision to claim good cause. In all other instances, the individual has 10 days from the date of the scheduled hearing to present reasons for failing to appear. The hearing examiner shall enter the good cause decision into the record.</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> 28 SDR 111, effective February 20, 2002.</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=28-1-61">28-1-61.</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=28-1-61">28-1-61.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:05:09 Postponement of IPV hearing.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:05:09"> <META NAME="Description" Content="Administrative Rules 67:48:05:09 Postponement of IPV hearing."> <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>67:48:05:09.&nbsp;&nbsp;Postponement of IPV hearing.</b> An IPV hearing may be postponed once if the individual requesting the postponement makes the request at least 10 days before the scheduled hearing.</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> 28 SDR 111, effective February 20, 2002.</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=28-1-61">28-1-61.</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=28-1-61">28-1-61.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:05:10 Disqualification hearing decision.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:05:10"> <META NAME="Description" Content="Administrative Rules 67:48:05:10 Disqualification hearing decision."> <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>67:48:05:10.&nbsp;&nbsp;Disqualification hearing decision.</b> The hearing officer shall conduct the hearing, arrive at a decision, and notify the individual and the department of the final decision within 90 days after the date the individual was notified of the hearing. If the hearing is postponed, the 90-day limit is extended by the length of the postponement.</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 decision must be based on clear and convincing evidence that demonstrates that the individual committed and intended to commit an IPV.</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> 28 SDR 111, effective February 20, 2002.</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=28-1-61">28-1-61.</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=28-1-61">28-1-61.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:05:11 Disqualification -- Notice -- Penalties.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:05:11"> <META NAME="Description" Content="Administrative Rules 67:48:05:11 Disqualification -- Notice -- Penalties."> <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>67:48:05:11.&nbsp;&nbsp;Disqualification -- Notice -- Penalties.</b> If an IPV exists, the department shall disqualify the individual from participating in the child care services program for the following lengths of time:</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; (1)&nbsp;&nbsp;For the first occurrence, one year;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (2)&nbsp;&nbsp;For the second occurrence, two years; and</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (3)&nbsp;&nbsp;For the third occurrence, permanently.</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; If the disqualified individual is a provider, the individual may not apply for any child care grants or receive any grant funding during the period of the disqualification.</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 department shall notify the individual in writing before the disqualification becomes effective.</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; A disqualification penalty remains in effect without the possibility of an administrative stay unless a court of appropriate jurisdiction reverses the finding on which the penalty was based. The duration of the disqualification penalty is not subject to review.</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; If a disqualification penalty and other sanctions or penalties apply, the disqualification penalty must be adhered to and is in addition to any other sanction or penalty that may be imposed by law for the same offense.</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> 28 SDR 111, effective February 20, 2002.</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=28-1-61">28-1-61.</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=28-1-61">28-1-61.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:48:05:12 Consolidation of administrative disqualification hearing with fair hearing.</title> <META NAME="Keywords" Content="Administrative Rules 67:48:05:12"> <META NAME="Description" Content="Administrative Rules 67:48:05:12 Consolidation of administrative disqualification hearing with fair hearing."> <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>67:48:05:12.&nbsp;&nbsp;Consolidation of administrative disqualification hearing with fair hearing.</b> The department may combine a fair hearing and an administrative disqualification hearing into a single hearing if the factual issues arise out of the same, or related, circumstances and the household receives prior notice that the hearings will be combined.</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> 28 SDR 111, effective February 20, 2002.</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=28-1-61">28-1-61.</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=28-1-61">28-1-61.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html>