S.D. Admin. R. 67:16:14:13
Except for items dispensed under the provisions of subdivision 67:16:14:06.06(2) or § 67:16:14:06.09, claims for items provided under this chapter must be submitted at the provider's usual and customary charge.
A claim for items dispensed under subdivision 67:16:14:06.06(2) or § 67:16:14:06.09 must be submitted at the provider's cost. To verify the charges, the provider must maintain a copy of the supplier's invoice showing the actual cost of the item to the provider and all discounts applied to the invoiced item. At the department's request, a provider must furnish information to substantiate a claim.
A provider may not submit a claim for items that have not been provided.
S.D. Admin. R. 67:16:14:13
General Authority: SDCL 28-6-1.
Law Implemented: SDCL 28-6-1.
Third-party liability, ch 67:16:26.