Nothing in this section requires a plan or issuer that has a network of providers to provide benefits for items or services described in § 20:06:54:01 that are delivered by an out-of-network provider. Moreover, nothing in this section precludes a plan or issuer that has a network of providers from imposing cost-sharing requirements for items or services described in § 20:06:54:01 that are delivered by an out-of-network provider.
S.D. Admin. R. 20:06:54:03
General Authority: SDCL 58-17-87, 58-18-79.
Law Implemented: SDCL 58-17-1.1, 58-17-1.2, 58-17-62, 58-17-87, 58-17-98, 58-18-36, 58-18-41, 58-18-79, 58-18-80, 58-18-83.