58-12-23. Application for or acceptance of medical assistance paid by department operates as release of information to facilitate coordination of benefits--Request.
Notwithstanding any provision of a policy, plan, contract, or certificate, an insurer shall recognize that an application for medical assistance or acceptance of medical assistance, paid by the Department of Social Services operates as a release of any information kept by the insurer that would facilitate efficient coordination of benefits between the department and the insurer, which may include:
(1)The name, address, date of birth, social security number if available, and unique health care identification number of the covered individual;
(2)The name, address, date of birth, social security number if available, policy number, group identification number of the policyholder, sponsor, or subscriber;
(3)The name and address of the employer if it is an employer-employee benefit plan; types of services covered under the plan or policy; and the name and address of the claims administrator for the policy or plan;
(4)Previously paid benefits including the name and address of the payee; and
(5)The name and address of claims processing or administration centers, or both.
Upon written request by the department, the insurer shall provide the requested information in writing within thirty calendar days of receipt of the request.
Source: SL 2005, ch 263, §2; SL 2007, ch 286, §1.
Structure South Dakota Codified Laws
Chapter 12 - Insurance Claims And Benefits
Section 58-12-1 - Forms for proof of loss--Furnishing by insurer on request.
Section 58-12-2 - Acts of insurer not constituting waiver of policy provision or defense.
Section 58-12-4 - Life and health insurance--Exemption of benefits and proceeds from execution.
Section 58-12-5 - "Annuity contract" defined.
Section 58-12-8 - Maximum amount of annuity exemption--Excess subject to levy.
Section 58-12-9 - Application of excess annuities to judgment--Factors considered.
Section 58-12-12 - Use of uniform health insurance claim forms.
Section 58-12-13 - Use of claim forms required by federal law excepted.
Section 58-12-14 - Promulgation of rules for uniform health insurance claim forms.
Section 58-12-15 - "Paintless dent repair" defined.
Section 58-12-18 - Compliance with § 58-12-16.
Section 58-12-19 - Clean claim defined.
Section 58-12-25 - Reimbursement to department for cost of services.
Section 58-12-26 - Insurer defined.
Section 58-12-27 - Department defined.
Section 58-12-28 - Provisions of chapter 1-27 not applicable to insurer records.
Section 58-12-31 - Definitions regarding standards for claims processing.
Section 58-12-32 - Application of standards for claims investigation and disposition.
Section 58-12-34 - Acts constituting unfair claims practices.
Section 58-12-35 - Notice of hearing.
Section 58-12-36 - Cease and desist order--Monetary penalty--Suspension or revocation of license.
Section 58-12-37 - Promulgation of rules regarding definitions and records.