S.D. Admin. R. 67:16:03:06.16

Current through Register Vol. 51, page 57, November 12, 2024

Section 67:16:03:06.16 - Rate of reimbursement if individual subject to care management remains in psychiatric unit beyond established discharge date

Reimbursement for services provided in an exempt psychiatric unit on behalf of an individual subject to care management is 50 percent of the per diem rate established in subdivision 67:16:03:06.06(3) if the following requirements are met:

(1) The care manager determined that the individual reached the individual's potential in the current setting or there is a recommendation through the care conference that the individual be transferred to long-term psychiatric care;

(2) The care manager established a discharge date;

(3) The care manager provided written notice of the established discharge date to the provider; and

(4) Because no alternative placement was available, the care manager authorized the individual to remain in the unit beyond the established discharge date. This authorization does not constitute a change in the established discharge date.

Services provided in an exempt unit that are not authorized by the care manager are not reimbursable.

S.D. Admin. R. 67:16:03:06.16

31 SDR 39, effective 9/29/2004.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.

Authorization for admission required, § 67:16:40:04; Admission requirements -- Psychiatric care, § 67:16:40:07.