S.D. Admin. R. 20:06:40:33
Nothing in § 20:06:40:32 limits the authority of a health care professional who is providing health care services to an individual to request that the individual undergo a genetic test.
Additionally, nothing in § 20:06:40:32 precludes a plan or issuer from obtaining and using the results of a genetic test in making a determination regarding payment. Therefore, if a plan or issuer conditions payment for an item or service based on its medical appropriateness and the medical appropriateness of the item or service depends on the genetic makeup of a patient, then the plan or issuer is permitted to condition payment for the item or service on the outcome of a genetic test. The plan or issuer may also refuse payment if the patient does not undergo the genetic test.
A plan or an issuer may only request the minimum amount of information necessary to make a determination regarding payment. The minimum amount of information necessary is determined in accordance with the minimum necessary standard in 45 CFR 164.502(b) of the privacy regulations issued under the Health Insurance Portability and Accountability Act.
S.D. Admin. R. 20:06:40:33
General Authority: SDCL 58-18-79, 58-18-87.
Law Implemented: SDCL 58-18-79.