<html xmlns="http://www.w3.org/1999/xhtml"> <head> <meta charset="UTF-8" /> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-41-52.1 - Collection for covered services prohibited.</title> <meta name="Generator" content="PowerTools for Open XML" /> <style>span { white-space: pre-wrap; } p.pt-Normal { 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.pt-SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.pt-CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.pt-Statute { 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.pt-DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } a.pt-000000 { text-decoration: none; } span.pt-000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.pt-NoIndent { text-indent: 0.00in; 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.pt-DefaultParagraphFont-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.pt-SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } body { text-decoration-skip-ink: none; } </style> </head> <body> <div> <p dir="ltr" class="pt-Normal"> <a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-52.1"> <span class="pt-SENU">58-41-52.1</span> </a> <span xml:space="preserve" class="pt-SENU">. </span> <span class="pt-CL">Collection for covered services prohibited.</span> </p> <p dir="ltr" class="pt-Statute"> <span xml:space="preserve" class="pt-DefaultParagraphFont">Except for coinsurance, deductibles, or copayments as specifically provided in the evidence of coverage, in no event, including nonpayment by the health maintenance organization, insolvency of the health maintenance organization, or breach of contract among the health maintenance organization, risk bearing entity, or participating provider, may a risk bearing entity or participating provider bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against an enrollee or a person other than the health maintenance organization acting on behalf of </span> <a id="_pagenumber31" class="pt-000000"></a> <span class="pt-DefaultParagraphFont">the enrollee for covered services provided. No risk bearing entity or participating provider, nor any agent, trustee or assignee of the risk bearing entity or participating provider may maintain an action at law against an enrollee to collect sums owed by the health maintenance organization.</span> </p> <p dir="ltr" class="pt-Normal"> <span xml:space="preserve" class="pt-000001"> </span> </p> <p dir="ltr" class="pt-NoIndent"> <span xml:space="preserve" class="pt-DefaultParagraphFont-000002">Source: </span> <span class="pt-SCL">SL 2020, ch 210, § 10.</span> </p> </div> </body> </html>