S.D. Admin. R. tit. 20, art. 20:06, ch. 20:06:55, app A
Appendix A - Model Choice of Health Care Professional Notice Language
. For health carries that require or allow for the designation of primary care health care professionals, beneficiaries or enrollees, insert:
[Name of health insurance issuer] generally [requires/allows] the designation of a primary care health care professional. You have the right to designate any primary care health care professional who participates in our network and who is available to accept you or your family members. [If the health insurance issuer designates a primary care health care professional automatically, insert: Until you make this designation, [name of health insurance issuer] designates one for you.] For information on how to select a primary care health care professional, and for a list of participating primary care health care professionals, contact the [health insurance issuer] at [insert contact information].
. For health insurance issuers that require or allow for the designation of a primary care health care professional for a child, add:
For children, you may designate a pediatrician as the primary care health care professional.
. For health insurance issuers that provide coverage for obstetric or gynecological care and require the designation by a participant, beneficiary or enrollee of a primary care health care professional, add:
You do not need prior authorization from [name of health insurance issuer] or from any other person, including a primary care health care professional, in order to obtain access to obstetrical or gynecological care from a health care professional in our network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals. For a list of participating health care professionals who specialize in obstetrics or gynecology, contact the [health insurance issuer] at [insert contact information].
S.D. Admin. R. tit. 20, art. 20:06, ch. 20:06:55, app A