<html> <head> <title>Rule 67:16:39:01 Definitions.</title> <META NAME="Keywords" Content="Administrative Rules 67:16:39:01"> <META NAME="Description" Content="Administrative Rules 67:16:39:01 Definitions."> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Generator content="Microsoft Word 15 (filtered)"> <style> <!-- /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4;} @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4;} @font-face {font-family:Times; panose-1:2 2 6 3 5 4 5 2 3 4;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in; margin-bottom:.0001pt; font-size:10.0pt; font-family:"Times",serif;} a:link, span.MsoHyperlink {color:blue; text-decoration:underline;} a:visited, span.MsoHyperlinkFollowed {color:purple; text-decoration:underline;} .MsoChpDefault {font-size:10.0pt; font-family:"Calibri",sans-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 link=blue vlink=purple> <div class=WordSection1> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>67:16:39:01.&nbsp;&nbsp;Definitions.</b> </span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>As</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> used in this chapter:</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (1)&nbsp;&nbsp;&quot;Designated covering provider,&quot;</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> means</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> another physician at the </span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>primary care provider's</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> clinic who has an arrangement with a </span><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>primary care provider</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> to act as the recipient's </span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>primary care provider</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> when the recipient's </span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>primary care provider</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> is unable to see the recipient;</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (2)&nbsp;&nbsp;&quot;Primary care </span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>provider program</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>,&quot;</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> means a program that requires</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> the management and treatment of a recipient's medical care by a single primary care provider, including necessary referrals by the primary care provider for specialty care or services;</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (3)&nbsp;&nbsp;&quot;Primary care provider,&quot;</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> means</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> the physician or facility chosen by the recipient or assigned by the department under &#167;&#167;&nbsp;67:16:39:05 and 67:16:39:06 to provide primary care </span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>provider program</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> services; and</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (4)&nbsp;&nbsp;&quot;Primary health care service,&quot;</span><span style='font-size:12.0pt;font-family: "Times New Roman",serif'> means</span><span style='font-size:12.0pt;font-family: "Times New Roman",serif'> the prescribing of or directing the use </span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>by</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> any person</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> of</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'> any drug, medicine, apparatus, or other agency</span><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>,</span><span style='font-size:12.0pt; font-family:"Times New Roman",serif'> for the cure, relief, or palliation of any ailment or disease of the mind or body</span><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>,</span><span style='font-size:12.0pt; font-family:"Times New Roman",serif'> or the cure or relief of any wound, fracture, bodily injury, or deformity.</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 20 SDR 135, effective February 22, 1994; 37 SDR 53, effective September 23, 2010; 46 SDR 50, effective October 10, 2019.</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&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></span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&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></span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>(1)(4)</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>.</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman",serif'>&nbsp;</span></p> </div> </body> </html>