S.D. Admin. R. 67:16:47:04

Current through Register Vol. 51, page 54, October 28, 2024

Section 67:16:47:04 - Treatment as a covered service - Conditions that must be met

Treatment at an eligible facility is a covered service if the following conditions are met:

(1) The individual is under the age of 21 or, if treatment began before the individual reached the age of 21, the treatment may continue until the date it is no longer needed or the date the individual reaches the age of 22, whichever occurs earlier;

(2) The state review team has determined that the conditions of § 67:16:47:04.02 have been met;

(3) The certification team has certified that the requirements contained in § 67:16:47:04.04 have been met;

(4) The services are expected to improve the individuals emotional and behavioral condition or prevent further regression; and

(5) The individual is eligible for medical assistance under article 67:46.

The referring source shall gather and supply to the department the documentation necessary to determine eligibility.

S.D. Admin. R. 67:16:47:04

32 SDR 33, effective 8/31/2005; 34 SDR 180, effective 12/26/2007.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 26-6-14, 28-6-1.

State review team, § 67:16:47:04.01. Certification team, § 67:16:47:04.03.