S.D. Admin. R. 20:06:39:46

Current through Register Vol. 50, page 159, June 17, 2024
Section 20:06:39:46 - Exceptions to requiring genetic testing

Nothing in § 20:06:39:45 limits the authority of a health care professional who is providing health care services to an individual to request that the individual undergo a genetic test.

Nothing in § 20:06:39:45 precludes an issuer offering health insurance in the individual market from obtaining and using the results of a genetic test in making a determination regarding payment. Therefore, if an issuer conditions payment for an item or service based on its medical appropriateness and the medical appropriateness of the item or service depends on a covered individual's genetic makeup, the issuer is permitted to condition payment on the outcome of a genetic test and may refuse payment if the covered individual does not undergo the genetic test. An issuer in the individual market may only request the minimum amount of information necessary to make a determination regarding payment. The minimum amount of information necessary is determined in accordance with the minimum necessary standard in 45 CFR 164.502(b) of the privacy regulations issued under the Health Insurance Portability and Accountability Act.

S.D. Admin. R. 20:06:39:46

37 SDR 47, effective 9/20/2010.

General Authority: SDCL 58-17-87.

Law Implemented: SDCL 58-17-87.