58-17F-15. Remedies available to director against health carrier found not in compliance.
In addition to any other remedies permitted by law, if the director determines that a health carrier has not contracted with enough participating providers to assure that covered persons have accessible health care services in a geographic area, that a health carrier's access plan does not assure reasonable access to covered benefits, that a health carrier has entered into a contract that does not comply with this chapter, or that a health carrier has not complied with a provision of this chapter, the director may institute a corrective action that shall be followed by the health carrier or may use any of the director's other enforcement powers to obtain the health carrier's compliance with this chapter.
A covered person shall have access to emergency services twenty-four hours a day, seven days a week to treat emergency medical conditions that require immediate medical attention. (SL 2012, ch 239, §1 provides: "The provisions of chapter 219 of the 2011 Session Laws shall be deemed repealed if the Patient Protection and Affordable Care Act, Pub.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.")
Source: SL 2011, ch 219, §15.
Structure South Dakota Codified Laws
Chapter 17F - Network Adequacy Standards
Section 58-17F-1 - Definitions.
Section 58-17F-2 - Health benefit plan defined.
Section 58-17F-3 - Medical director required for managed care plans.
Section 58-17F-7 - Health carrier to ensure provider proximity to covered persons.
Section 58-17F-9 - Factors to consider in determining network adequacy.
Section 58-17F-11 - Requirements for health carrier and providers in managed care plans.
Section 58-17F-14 - Contract does not relieve health carrier of liability.
Section 58-17F-15 - Remedies available to director against health carrier found not in compliance.
Section 58-17F-16 - Managed care contractor to register with director.
Section 58-17F-17 - Filing changes in registration information.
Section 58-17F-18 - Request for information from managed care contractor.
Section 58-17F-19 - Activities of nonregistered managed care contractor prohibited.
Section 58-17F-20 - Registration fee for managed care contractor.