S.D. Admin. R. 22:02:02:07

Current through Register Vol. 51, page 34, September 9, 2024

Section 22:02:02:07 - Reasons for claim denial

The board shall deny a county's claim for reimbursement for any of the following reasons:

(1) The county has not paid its CCPR annual assessment;

(2) The county has not paid its supplemental CCPR fund assessment;

(3) The county has not paid the first $20,000 for the individual for the 12-month period;

(4) The county has not provided the evidence required under § 22:02:02:05;

(5) The service was provided before January 1, 1985;

(6) The service was provided before the date of county participation;

(7) The county has not been approved as a participating county;

(8) The request for reimbursement has been delayed and the county failed to notify the department according to § 22:02:02:03;

(9) The claim is for an organ transplant for which the county has failed to meet the requirements of SDCL 28-13A-13;

(10) The county failed to follow its guidelines when determining eligibility;

(11) The county failed to pursue other third-party payment sources;

(12) The individual was not eligible for county poor relief; or

(13) The claim exceeds the payment limits established in § 22:02:02:08.

S.D. Admin. R. 22:02:02:07

11 SDR 144, effective 5/2/1985, amended effective 7/1/1985; 19 SDR 76, effective 11/23/1992; 22 SDR 2, effective 7/17/1995; 25 SDR 69, effective 11/12/1998; transferred from § 67:19:02:07, 36 SDR 27, effective 8/26/2009.

General Authority: SDCL 28-13A-4.

Law Implemented: SDCL 28-13A-4.