<html xmlns="http://www.w3.org/1999/xhtml" lang="en-US"><head><meta charset="UTF-8"><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17H-22 - Health carrier oversight of delegated activities--Requirements.</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s355b901b3d6140fe998ac23ed176b057Normal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s355b901b3d6140fe998ac23ed176b057SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s355b901b3d6140fe998ac23ed176b057CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s355b901b3d6140fe998ac23ed176b057Normal-000000 { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; 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padding: 0; } span.s355b901b3d6140fe998ac23ed176b057DefaultParagraphFont-000004 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } body { text-decoration-skip-ink: none; } </style><meta name="viewport" content="width=device-width, initial-scale=1"><meta name="twitter:card" content="summary"><meta property="og:title" content="SD 58-17H-22 - Health carrier oversight of delegated activities--Requirements."><meta property="og:description" content="SDLRC Codified Law 58-17H-22 - Health carrier oversight of delegated activities--Requirements."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes/58-17H-22"><meta property="og:image" content="https://lawmakerdocuments.blob.core.usgovcloudapi.net/photos/logoshape.webp"><meta property="og:site_name" content="South Dakota Legislature"></head><body><div><p dir="ltr" class="s355b901b3d6140fe998ac23ed176b057Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-17H-22" rel="noopener"><span class="s355b901b3d6140fe998ac23ed176b057SENU">58-17H-22</span></a><span xml:space="preserve" class="s355b901b3d6140fe998ac23ed176b057SENU">. </span><span class="s355b901b3d6140fe998ac23ed176b057CL">Health carrier oversight of delegated activities--Requirements.</span></p><p dir="ltr" class="s355b901b3d6140fe998ac23ed176b057Normal-000000"><span class="s355b901b3d6140fe998ac23ed176b057DefaultParagraphFont">If a health carrier delegates any utilization review activities to a utilization review organization, the health carrier shall maintain adequate oversight, which shall include:</span></p><p dir="ltr" class="s355b901b3d6140fe998ac23ed176b057Normal-000001"><span class="s355b901b3d6140fe998ac23ed176b057DefaultParagraphFont">(1)    A written description of the utilization review organization's activities and responsibilities, including reporting requirements;</span></p><p dir="ltr" class="s355b901b3d6140fe998ac23ed176b057Normal-000001"><span class="s355b901b3d6140fe998ac23ed176b057DefaultParagraphFont">(2)    Evidence of formal approval of the utilization review organization program by the health carrier; and</span></p><p dir="ltr" class="s355b901b3d6140fe998ac23ed176b057Normal-000001"><span class="s355b901b3d6140fe998ac23ed176b057DefaultParagraphFont">(3)    A process by which the health carrier evaluates the performance of the utilization review organization.</span></p><p dir="ltr" class="s355b901b3d6140fe998ac23ed176b057Normal"><span xml:space="preserve" class="s355b901b3d6140fe998ac23ed176b057000002"> </span></p><p dir="ltr" class="s355b901b3d6140fe998ac23ed176b057Normal"><span class="s355b901b3d6140fe998ac23ed176b057SCL">Source:</span><span xml:space="preserve" class="s355b901b3d6140fe998ac23ed176b057SCL-000003"> SL 2011, ch 219, § 47.</span></p><p dir="ltr" class="s355b901b3d6140fe998ac23ed176b057Normal"><span xml:space="preserve" class="s355b901b3d6140fe998ac23ed176b057000002"> </span></p><p dir="ltr" class="s355b901b3d6140fe998ac23ed176b057Normal"><span xml:space="preserve" class="s355b901b3d6140fe998ac23ed176b057DefaultParagraphFont-000004">Commission Note: </span><span class="s355b901b3d6140fe998ac23ed176b057DefaultParagraphFont">SL 2012, ch 239, § 1 provides: "The provisions of chapter 219 of the 2011 Session Laws shall be deemed repealed if the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119 (2010), as amended by the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, 124 Stat. 1029 (2010) is found to be unconstitutional in its entirety by a final decision of a federal court of competent jurisdiction and all appeals exhausted or time for appeals elapsed."</span></p></div></body></html>