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2022 South Dakota Codified Laws
Title 58 - Insurance
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-4 - Health carrier to provide written information to prospective enrollees--Specific information required.
- Section 58-17F-5 - Health carrier to maintain provider network sufficient to assure services without unreasonable delay--Emergency services--Determination of sufficiency.
- Section 58-17F-6 - Where provider network is insufficient, covered benefit to be made available at no greater cost.
- Section 58-17F-7 - Health carrier to ensure provider proximity to covered persons.
- Section 58-17F-8 - Health carrier to monitor provider ability, capacity, and authority--Financial capability to be monitored in capitated plans.
- Section 58-17F-9 - Factors to consider in determining network adequacy.
- Section 58-17F-10 - Access plan required for managed care plans--Annual update--Contents--Exemptions for discounted fee-for-service networks.
- Section 58-17F-11 - Requirements for health carrier and providers in managed care plans.
- Section 58-17F-12 - Provisions governing contractual arrangements between health carriers and intermediaries.
- Section 58-17F-13 - Sample contract forms to be filed with director--Material changes to be submitted--Certain changes not material--Director's inaction within certain time deemed approval--Contract copies to be provided upon request.
- 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.
- Section 58-17F-21 - Promulgation of rules.
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