28-13-27. Hospitalization of poor persons--Definition of terms.
Terms used in this chapter mean:
(1)"Actual cost of hospitalization," the actual cost to a hospital of providing hospital services to a medically indigent person, determined by applying the ratios of costs to charges appearing on the statement of costs required in §28-13-28 to charges at the hospital in effect at the time the hospital services are provided;
(2)"Emergency hospital services," treatment in the most appropriate hospital available to meet the emergency need. The physician, physician assistant, or certified nurse practitioner on duty or on call at the hospital must determine whether the individual requires emergency hospital care. The need for emergency hospital care is established if the absence of emergency care is expected to result in death, additional serious jeopardy to the individual's health, serious impairment to the individual's bodily functions, or serious dysfunction of any bodily organ or part. The term does not include care for which treatment is available and routinely provided in a clinic or physician's office;
(3)"Hospital," any hospital licensed as such by the state in which it is located;
(4)"Household," the patient, minor children of the patient living with the patient, and anyone else living with the patient to whom the patient has the legal right to look for support;
(5)"Nonemergency care," hospitalization which is medically necessary and recommended by a physician licensed under chapter 36-4 but does not require immediate care or attention;
(6)"Indigent by design," an individual who meets any one of the following criteria:
(a)Is able to work but has chosen not to work;
(b)Is a student at a postsecondary institution who has chosen not to purchase health insurance;
(c)Has failed to purchase or elect major medical health insurance or health benefits made available through an employer-based health benefit plan although the person was financially able, pursuant to §28-13-32.11, to purchase or elect the insurance or health benefits;
(d)Has failed to purchase available major medical health insurance although the individual was insurable and was financially able, pursuant to §28-13-32.11, to purchase the insurance. For purposes of this subdivision, an individual is presumed insurable unless the individual can produce sufficient evidence to show that the individual was declined major medical insurance by an insurance company and the individual did not qualify for any guarantees of major medical insurance available through any legal or contractual right that was not exercised; or
(e)Has transferred resources for purposes of establishing eligibility for medical assistance available under the provisions of this chapter. The lookback period for making this determination includes the thirty-six month period immediately prior to the onset of the individual's illness and continues through the period of time for which the individual is requesting services.
Source: SL 1953, ch 131, §1; SDC Supp 1960, §27.12B01; SL 1980, ch 202, §4; SL 1984, ch 203, §3; SL 1988, ch 225, §1; SL 1991, ch 227, §1; SL 1997, ch 170, §3; SL 2000, ch 134, §1; SL 2017, ch 171, §50.
Structure South Dakota Codified Laws
Title 28 - Public Welfare and Assistance
Chapter 13 - County Poor Relief
Section 28-13-1 - County duty to relieve poor persons--Taxation--Determination of eligibility.
Section 28-13-1.1 - "Indigent or poor person" defined--Eligibility standards.
Section 28-13-1.2 - Considerations in establishing eligibility standards.
Section 28-13-1.3 - Medically indigent person defined.
Section 28-13-1.4 - Appeal regarding medical indigence.
Section 28-13-2 - Residency acquired for poor relief purposes.
Section 28-13-3 - Residency required for assistance--Establishment.
Section 28-13-5 - Children's residency.
Section 28-13-8 - Residency continued until lost by new residency.
Section 28-13-12 - Residency not established by state acceptance of application.
Section 28-13-14 - Residency not established by residence in health care facility.
Section 28-13-16 - County commissioners to have responsibility for care and relief of poor persons.
Section 28-13-16.1 - Waiting period imposed at board's discretion while residency investigated.
Section 28-13-16.2 - Intentional fraud or deceit to receive assistance.
Section 28-13-17 - Proceedings by and against commissioners in name of county.
Section 28-13-18 - Record of poor relief payments available in investigation of residency.
Section 28-13-20 - Services required of applicant--Contract for repayment of assistance.
Section 28-13-20.2 - Refusal to work without just cause--Eligibility for assistance terminated.
Section 28-13-22 - Employment of welfare workers to distribute funds and supplies to poor.
Section 28-13-23 - Annual allowances to competent poor persons.
Section 28-13-27 - Hospitalization of poor persons--Definition of terms.
Section 28-13-27.1 - Medically necessary hospital services.
Section 28-13-27.2 - Cost guidelines for medical and remedial services.
Section 28-13-30 - Approval of statement by secretary--Modification of items in statement.
Section 28-13-32 - County commissioners' objections to statements.
Section 28-13-32.5 - Determining medical indigence--Annual income guideline.
Section 28-13-32.6 - Housing indexes by county.
Section 28-13-32.7 - Determining household income--Sources.
Section 28-13-32.8 - Household resources.
Section 28-13-32.9 - Determination of person's ability to pay--Factors.
Section 28-13-32.10 - Indigency by design.
Section 28-13-32.11 - Determination of household's ability to purchase health insurance.
Section 28-13-33.1 - Experimental procedures and treatment for medically indigent patient.
Section 28-13-33.2 - Billing for care of medically indigent patients.
Section 28-13-34.2 - Release of information.
Section 28-13-36 - Contractual arrangements between county and hospital not impaired.
Section 28-13-37 - County duty to relieve nonresidents in distress.
Section 28-13-37.1 - Medical review by county or Department of Social Services.
Section 28-13-38 - Temporary relief to nonresident--Reimbursement by home county.
Section 28-13-38.1 - When hospitals outside state are eligible for reimbursement by county.
Section 28-13-40 - Appeal to circuit court from county commissioners--Direction for assistance.
Section 28-13-42 - Names of recipients not released for publication.
Section 28-13-43 - Assignment or transfer of property to qualify for assistance as misdemeanor.
Section 28-13-44 - Bankruptcy not admissible in making determination of indigency.