S.D. Admin. R. 67:16:25:06.01

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

Section 67:16:25:06.01 - Transportation services provided by community transportation provider

Community transportation services are covered if the following requirements are met:

(1) The transportation provider is a governmental entity, secure medical transportation provider, or registered as a nonprofit organization with the South Dakota Secretary of State;

(2) The transportation provider is domiciled in the State of South Dakota or enrolled as a Medicaid transportation provider in the entity or organization's state of domicile;

(3) The entity or organization has a signed transportation provider agreement with the department to furnish nonemergency medical transportation to recipients;

(4) Transportation is from an eligible recipient's residence, bus stop nearest to the recipient's residence, place of work, or school to a medical provider, between medical providers, or from a medical provider to the recipient's residence, bus stop nearest to the recipient's residence, place of work, or school. A recipient's residence does not include a hospital, penal institution, detention center, campus setting, nursing facility, an intermediate care facility for individuals with intellectual disabilities, or an institute for the treatment of an individual with a mental disease;

(5) Transportation is to or from medically necessary examinations or treatment when the services are covered under article 67:16 and are provided by a provider who is enrolled or eligible for enrollment in the medical assistance program; and

(6) Transportation is to the closest facility or medical provider capable of providing the necessary services, unless the recipient has a written referral or a written authorization from a medical provider in the recipient's medical community.

S.D. Admin. R. 67:16:25:06.01

16 SDR 234, effective 7/1/1990; 17 SDR 201, effective 7/1/1991; 20 SDR 126, effective 2/10/1994; 25 SDR 69, effective 11/12/1998; 26 SDR 157, effective 6/7/2000; 35 SDR 253, effective 5/12/2009; 40 SDR 122, effective 1/8/2014; 44 SDR 94, effective 12/4/2017; 45 SDR 082, effective 12/10/2018; 48 SDR 39, effective 10/3/2021

General Authority: SDCL 28-6-1(1)(2).

Law Implemented: SDCL 28-6-1.