58-17D-4. Utilization review to be administered by qualified professional.
Any utilization review pursuant to this chapter shall be administered by a qualified licensed health care professional. Any adverse determination shall be evaluated by an appropriately licensed and clinically qualified health care professional. Any utilization review evaluation shall use generally accepted standards for treatment of the illness, injury, or condition reviewed. Any utilization review opinion shall be signed by the professional who performed the review.
Source: SL 2002, ch 231, ยง4.
Structure South Dakota Codified Laws
Chapter 17D - Standards For Utilization Review For Property And Casualty Insurers
Section 58-17D-1 - Definitions.
Section 58-17D-4 - Utilization review to be administered by qualified professional.
Section 58-17D-5 - Certain basis for fees prohibited.
Section 58-17D-6 - Insurer denying policyholder's claim to provide for reconsideration.