<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-49 - Promulgation of rules.</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s8974b8debec14d59b4c7027c4ce30e05Normal { 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.s8974b8debec14d59b4c7027c4ce30e05SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s8974b8debec14d59b4c7027c4ce30e05CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s8974b8debec14d59b4c7027c4ce30e05Normal-000000 { text-indent: 0.50in; 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.s8974b8debec14d59b4c7027c4ce30e05DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s8974b8debec14d59b4c7027c4ce30e05Normal-000001 { margin-left: 0.70in; text-indent: -0.45in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } p.s8974b8debec14d59b4c7027c4ce30e05Normal-000002 { text-indent: 0.25in; 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.s8974b8debec14d59b4c7027c4ce30e05000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s8974b8debec14d59b4c7027c4ce30e05SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s8974b8debec14d59b4c7027c4ce30e05SCL-000004 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s8974b8debec14d59b4c7027c4ce30e05DefaultParagraphFont-000005 { 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-49 - Promulgation of rules."><meta property="og:description" content="SDLRC Codified Law 58-17H-49 - Promulgation of rules."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes/58-17H-49"><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="s8974b8debec14d59b4c7027c4ce30e05Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-17H-49" rel="noopener"><span class="s8974b8debec14d59b4c7027c4ce30e05SENU">58-17H-49</span></a><span xml:space="preserve" class="s8974b8debec14d59b4c7027c4ce30e05SENU">. </span><span class="s8974b8debec14d59b4c7027c4ce30e05CL">Promulgation of rules.</span></p><p dir="ltr" class="s8974b8debec14d59b4c7027c4ce30e05Normal-000000"><span xml:space="preserve" class="s8974b8debec14d59b4c7027c4ce30e05DefaultParagraphFont">The director may, after consultation with the secretary, promulgate rules, pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes?Statute=1-26" rel="noopener"><span class="s8974b8debec14d59b4c7027c4ce30e05DefaultParagraphFont">1-26</span></a><span class="s8974b8debec14d59b4c7027c4ce30e05DefaultParagraphFont">, to carry out the provisions of this chapter. The rules shall provide for a timely administration of utilization review by the public and assure that utilization review decisions are made in a fair and clinically acceptable manner. The rules may include the following:</span></p><p dir="ltr" class="s8974b8debec14d59b4c7027c4ce30e05Normal-000001"><span class="s8974b8debec14d59b4c7027c4ce30e05DefaultParagraphFont">(1)    Definition of terms;</span></p><p dir="ltr" class="s8974b8debec14d59b4c7027c4ce30e05Normal-000001"><span class="s8974b8debec14d59b4c7027c4ce30e05DefaultParagraphFont">(2)    Timing, form, and content of reports;</span></p><p dir="ltr" class="s8974b8debec14d59b4c7027c4ce30e05Normal-000001"><span class="s8974b8debec14d59b4c7027c4ce30e05DefaultParagraphFont">(3)    Application of clinical criteria as it relates to utilization review;</span></p><p dir="ltr" class="s8974b8debec14d59b4c7027c4ce30e05Normal-000001"><span class="s8974b8debec14d59b4c7027c4ce30e05DefaultParagraphFont">(4)    Written determinations; and</span></p><p dir="ltr" class="s8974b8debec14d59b4c7027c4ce30e05Normal-000001"><span class="s8974b8debec14d59b4c7027c4ce30e05DefaultParagraphFont">(5)    Utilization review procedures.</span></p><p dir="ltr" class="s8974b8debec14d59b4c7027c4ce30e05Normal-000002"><span xml:space="preserve" class="s8974b8debec14d59b4c7027c4ce30e05DefaultParagraphFont">The director may promulgate rules, pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes?Statute=1-26" rel="noopener"><span class="s8974b8debec14d59b4c7027c4ce30e05DefaultParagraphFont">1-26</span></a><span class="s8974b8debec14d59b4c7027c4ce30e05DefaultParagraphFont">, pertaining to claims for group disability income plans. The rules shall be consistent with applicable federal requirements included in 29 CFR Part 2560 as amended to January 1, 2011.</span></p><p dir="ltr" class="s8974b8debec14d59b4c7027c4ce30e05Normal"><span xml:space="preserve" class="s8974b8debec14d59b4c7027c4ce30e05000003"> </span></p><p dir="ltr" class="s8974b8debec14d59b4c7027c4ce30e05Normal"><span class="s8974b8debec14d59b4c7027c4ce30e05SCL">Source:</span><span xml:space="preserve" class="s8974b8debec14d59b4c7027c4ce30e05SCL-000004"> SL 2011, ch 219, § 74.</span></p><p dir="ltr" class="s8974b8debec14d59b4c7027c4ce30e05Normal"><span xml:space="preserve" class="s8974b8debec14d59b4c7027c4ce30e05000003"> </span></p><p dir="ltr" class="s8974b8debec14d59b4c7027c4ce30e05Normal"><span xml:space="preserve" class="s8974b8debec14d59b4c7027c4ce30e05DefaultParagraphFont-000005">Commission Note: </span><span class="s8974b8debec14d59b4c7027c4ce30e05DefaultParagraphFont">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>