S.D. Admin. R. 67:16:16:01

Current through Register Vol. 51, page 57, November 12, 2024

Section 67:16:16:01 - Definitions

Terms used in this chapter mean:

(1) "Facility," a public or private institution licensed by an agency of the state of South Dakota or owned and operated by the state of South Dakota and certified by the department as a provider of care under the medical assistance program for eligible individuals with intellectual disabilities, persons with a related condition, or individuals who are mentally or emotionally impaired;

(2) "Monthly care cost," the total monthly dollar amount payable by or in behalf of an eligible individual;

(3) "Review team," a team consisting of a physician, a registered nurse, a social worker, and other professionals as required which conducts on-site reviews and inspections of facilities for individuals with intellectual disabilities or emotional impairments; and

(4) "Utilization review," the assessment of the necessity for initial medical care or services and the periodic reassessment of the continued need for medical care or services by the review team.

S.D. Admin. R. 67:16:16:01

1 SDR 30, effective 10/13/1974; 4 SDR 88, effective 6/26/1978; 7 SDR 66, 7 SDR 89, effective 7/1/1981; 9 SDR 11, effective 8/1/1982; 16 SDR 235, effective 7/5/1990; 26 SDR 168, effective 7/1/2000; 40 SDR 122, effective 1/8/2014.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.

Title XIX of the Social Security Act, 42 U.S.C. § 1396 d.