S.D. Admin. R. 44:18:01:01

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

Section 44:18:01:01 - Definitions

Terms defined in SDCL 58-41-1 and 58-41-2 have the same meaning in this chapter. In addition, terms used in this chapter mean:

(1) "Emergency care," those professional health services immediately necessary to preserve life or stabilize health due to the sudden, severe, and unforeseen onset of illness or accidental bodily injury;

(2) "Health care delivery system," a regularly interacting and interdependent group of providers who furnish comprehensive health maintenance services;

(3) "HMO," the acronym for health maintenance organization as defined in SDCL 58-41-2;

(4) "Out-of-area health care services," those services provided outside of the HMO's geographic service area, as the area is described in the HMO's application for a certificate of authority and in subsequent changes to the application filed with the secretary;

(5) "Primary care physician," a person who is licensed to practice medicine in South Dakota by the South Dakota board of medical and osteopathic examiners and who provides direct patient care and practices principally in one of the four primary care specialties, general or family practice, general internal medicine, pediatrics, and obstetrics and gynecology; and

(6) "Timely provision of care," health care services which are administered within a time which does not compromise the patient's health condition and is within a waiting period comparable to the acceptable practices of the existing health care delivery systems in the proposed geographic area, as determined by the secretary, unless uncontrollable circumstances exist.

S.D. Admin. R. 44:18:01:01

12 SDR 50, effective 9/29/1985.

General Authority: SDCL 58-41-67.

Law Implemented: SDCL 58-41-12.