S.D. Admin. R. 20:06:40:17.02

Current through Register Vol. 51, page 67, December 16, 2024

Section 20:06:40:17.02 - Prohibited practices

A group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, may not:

(1) Deny to a patient eligibility, or continued eligibility, to enroll or to renew coverage under the terms of the plan, solely for the purpose of avoiding the requirements of § 20:06:40:17; or

(2) Penalize or otherwise reduce or limit the reimbursement of an attending provider, or provide incentives (monetary or otherwise) to an attending provider, to induce such provider to provide care to an individual participant or beneficiary in a manner inconsistent with § 20:06:40:17.

S.D. Admin. R. 20:06:40:17.02

27 SDR 15, effective 9/6/2000.

General Authority: SDCL 58-18-79.

Law Implemented: SDCL 58-18-79.