Because the county is the payor of last resort, a county must pursue the availability of a third-party payment source before accepting responsibility for a catastrophic claim. A third-party payment source is the obligation of an entity other than the county for either partial or full payment of the medical cost of injury, disease, or disability. Third-party payment sources include coverage such as Medicare, Medicaid, private health insurance, workers' compensation, supplemental security income, disability insurance, and automobile insurance.
The county must be able to document pursuit of the availability of a third-party payment source. The documentation must be maintained in the individual's record. When the claim is subsequently submitted to the CCPR program for payment, evidence of the third-party payment or rejection must accompany the claim.
S.D. Admin. R. 22:02:02:10
General Authority: SDCL 28-13A-4.
Law Implemented: SDCL 28-13A-4.