S.D. Admin. R. 20:06:33:04

Current through Register Vol. 51, page 67, December 16, 2024
Section 20:06:33:04 - Centers of Excellence - Access plans

Each contracted Center of Excellence and each contracted network of a Center of Excellence must be included in a health carrier's access plan. For purposes of network adequacy pursuant to §§58-17F-5 to 58-17F-9, inclusive, the health carrier's entire Center of Excellence network including both direct contracted Centers of Excellence and contracted networks shall be considered. A health carrier may not contract with a Center of Excellence network or any other network that is not registered pursuant to §58-17F-16. Nothing in this section affects the ability of carriers to select network providers as permitted by SDCL subdivision 58-17F-11(3). For purposes of this section a Center of Excellence means a provider of transplant services that is medically recognized as having special expertise to perform a particular transplant or transplants. Transplant providers that separately contract with a health carrier do not constitute a network pursuant to this section.

S.D. Admin. R. 20:06:33:04

36 SDR 96, effective 12/9/2009; 37 SDR 241, effective 7/1/2011.

General Authority: SDCL 58-17F-10, 58-17F-21(4)(5).

Law Implemented: SDCL 58-17F-5, 58-17F-6, 58-17F-7, 58-17F-8, 58-17F-9.