58-17H-36. Filing changes in registration information.
Any utilization review organization which has previously registered in this state shall, on or before July first of each year, file with the Division of Insurance any changes to the initial or subsequent annual registration for the utilization review organization. (SL 2012, ch 239, §1 provides: "The provisions of chapter 219 of the 2011 Session Laws shall be deemed repealed if the Patient Protection and Affordable Care Act, Pub.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, §61.
Structure South Dakota Codified Laws
Chapter 17H - Utilization Review And Benefit Determinations
Section 58-17H-1 - Definitions.
Section 58-17H-2 - Health benefit plan defined.
Section 58-17H-3 - Urgent care request defined.
Section 58-17H-4 - Applicability of chapter.
Section 58-17H-6 - In-network emergency services.
Section 58-17H-7 - Cost-sharing requirements for out-of-network emergency services.
Section 58-17H-9 - Exceptions for payments by capitated and other plans without negotiated fees.
Section 58-17H-10 - Negotiated amounts for in-network providers for a particular emergency service.
Section 58-17H-11 - General cost-sharing requirements allowed.
Section 58-17H-12 - Access to representative for post-evaluation or post-stabilization services.
Section 58-17H-14 - Health carrier responsibility for utilization review activities.
Section 58-17H-16 - Written utilization review program required--Contents of program document.
Section 58-17H-18 - Program to be administered by qualified licensed health care professionals.
Section 58-17H-19 - Determinations to be issued in timely manner--Process to ensure consistency.
Section 58-17H-20 - Effectiveness and efficiency of program to be routinely reviewed.
Section 58-17H-21 - Data systems to support program activities and generate management reports.
Section 58-17H-22 - Health carrier oversight of delegated activities--Requirements.
Section 58-17H-24 - Health carrier to provide free access to review staff.
Section 58-17H-25 - Only information necessary for review or determination to be collected.
Section 58-17H-26 - Independence and impartiality required for utilization review.
Section 58-17H-27 - Written procedures required for making determinations--Notification.
Section 58-17H-29 - Concurrent review determinations--Timing--Notification requirements.
Section 58-17H-30 - Retrospective review determinations--Timing--Notification requirements.
Section 58-17H-32 - Notification of adverse determination--Contents.
Section 58-17H-35 - Registration of utilization review organizations--Required information.
Section 58-17H-36 - Filing changes in registration information.
Section 58-17H-37 - Requests for information from utilization review organizations.
Section 58-17H-38 - Activities of nonregistered utilization review organizations prohibited.
Section 58-17H-39 - Registration fee for utilization review organizations.
Section 58-17H-42 - Insufficient information for determination of prospective urgent care requests.
Section 58-17H-43 - Urgent care requests--Timely notification of determination.
Section 58-17H-44 - Time within which to submit necessary information.
Section 58-17H-47 - Calculation of time periods for determination.
Section 58-17H-48 - Notification of adverse determination--Requirements.
Section 58-17H-49 - Promulgation of rules.
Section 58-17H-50 - Coverage for cancer treatment medication.
Section 58-17H-51 - Reclassification of benefits with respect to cancer treatment medications.
Section 58-17H-52 - Medical management practices complying with chapter.
Section 58-17H-53 - Step therapy protocols.
Section 58-17H-54 - Step therapy protocols--Process--Transparency.