Chapter
NETWORK ADEQUACY STANDARDS
- S.D. Codified Laws § 58-17F-1— Definitions
- S.D. Codified Laws § 58-17F-2— Health benefit plan defined
- S.D. Codified Laws § 58-17F-3— Medical director required for managed care plans
- S.D. Codified Laws § 58-17F-4— Health carrier to provide written information to prospective enrollees--Specific information required
- S.D. Codified Laws § 58-17F-5— Health carrier to maintain provider network sufficient to assure services without unreasonable delay--Emergency services--Determination of sufficiency
- S.D. Codified Laws § 58-17F-6— Where provider network is insufficient, covered benefit to be made available at no greater cost
- S.D. Codified Laws § 58-17F-7— Health carrier to ensure provider proximity to covered persons
- S.D. Codified Laws § 58-17F-8— Health carrier to monitor provider ability, capacity, and authority--Financial capability to be monitored in capitated plans
- S.D. Codified Laws § 58-17F-9— Factors to consider in determining network adequacy
- S.D. Codified Laws § 58-17F-10— Access plan required for managed care plans--Annual update--Contents--Exemptions for discounted fee-for-service networks
- S.D. Codified Laws § 58-17F-11— Requirements for health carrier and providers in managed care plans
- S.D. Codified Laws § 58-17F-12— Provisions governing contractual arrangements between health carriers and intermediaries
- S.D. Codified Laws § 58-17F-13— Sample contract forms to be filed with director--Material changes to be submitted--Certain changes not material--Director's inaction within certain time deemed approval--Contract copies to be provided upon request
- S.D. Codified Laws § 58-17F-14— Contract does not relieve health carrier of liability
- S.D. Codified Laws § 58-17F-15— Remedies available to director against health carrier found not in compliance
- S.D. Codified Laws § 58-17F-16— Managed care contractor to register with director
- S.D. Codified Laws § 58-17F-17— Filing changes in registration information
- S.D. Codified Laws § 58-17F-18— Request for information from managed care contractor
- S.D. Codified Laws § 58-17F-19— Activities of nonregistered managed care contractor prohibited
- S.D. Codified Laws § 58-17F-20— Registration fee for managed care contractor
- S.D. Codified Laws § 58-17F-21— Promulgation of rules