S.D. Admin. R. 44:06:06:07

Current through Register Vol. 51, page 67, December 16, 2024

Section 44:06:06:07 - Services and conditions not covered

Services and conditions not covered under the CSHS program include the following:

(1) Doctor visits for routine care unless recommended by the specialist in charge;

(2) Routine dental care, except for that requested by an orthodontist for a child with a cleft palate;

(3) Surgical procedures with any associated hospitalizations except upon individual case review;

(4) Cosmetic surgery except upon individual case review for cleft lip or palate or both;

(5) Acute accidents or illnesses;

(6) Vocational rehabilitation;

(7) Special education;

(8) Appliance repairs;

(9) Room and board;

(10) Ambulance charges;

(11) Supplies and appliances as follows:

(a) Artificial eyes;

(b) Catheters except for renal disorders;

(c) Contact lenses except upon individual case review for congenital cataracts;

(d) Crutches;

(e) Over-the-counter drugs and medications, except upon individual case review;

(f) Glasses;

(g) Hearing aids, except upon individual review;

(h) Immunizations;

(i) Kidney dialysis machines;

(j) Prosthesis, except upon individual review;

(k) Shoes;

(l) Special beds;

(m) Speech appliances except for obturators;

(n) Walkers;

(o) Wheelchairs; and

(p) Dietary supplements, except upon individual case review;

(12) Infectious diseases;

(13) Organ transplants;

(14) Fractures or other acute trauma;

(15) Kidney dialysis;

(16) Undescended testicles;

(17) Intestinal obstruction;

(18) Imperforate anus;

(19) Experimental procedures; and

(20) Psychological evaluations.

S.D. Admin. R. 44:06:06:07

6 SDR 93, effective 7/1/1980; 8 SDR 155, effective 5/27/1982; 9 SDR 162, effective 6/20/1983; 14 SDR 182, effective 7/11/1988; 20 SDR 91, effective 12/19/1993; 23 SDR 91, effective 12/9/1996; 30 SDR 198, effective 6/23/2004; 33 SDR 106, effective 12/26/2006; 34 SDR 93, effective 10/17/2007.

General Authority: SDCL 34-1-21.

Law Implemented: SDCL 34-1-21.