S.D. Admin. R. 67:16:40:12

Current through Register Vol. 50, page 162, June 24, 2024
Section 67:16:40:12 - Hospital to supply information to care manager

Within 24 hours after the care manager's request, a facility must provide or make available the active or closed admission records of those individuals subject to care management.

Records include the individual's complete medical history, the progress notes, results from laboratory tests and X rays, and any other documentation which may be necessary to determine the medical necessity of an individual's admission or continued stay.

The facility must inform the care manager of planned care conferences and allow the care manager to attend the conferences. The care manager may use the information received at the conference when determining the medical necessity for an individual's admission to or continued stay in the facility.

S.D. Admin. R. 67:16:40:12

21 SDR 123, effective 1/19/1995; 44 SDR 94, effective 12/4/2017

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1(1)(4).

Covered services must be medically necessary, § 67:16:01:06.02.