S.D. Admin. R. 67:16:26:01

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

Section 67:16:26:01 - Definitions

Terms used in this chapter mean:

(1) "Private health insurance," medical or hospital insurance coverage with benefits payable to or in behalf of an eligible recipient;

(2) "Probable existence of third-party liability," an indication in the individual's case record which suggests that a possible third-party resource exists which may be liable for the individual's medical expenses, or the identification of a third-party resource with a reasonable expectation that the third-party resource will pay on the claim; and

(3) "Third-party liability" or "third-party payment source," the obligation of an entity other than the medical assistance program for either partial or full payment of the medical cost of injury, disease, or disability. Third-party liability sources include coverage such as Medicare, private health insurance, worker's compensation, disability insurance, and automobile insurance.

S.D. Admin. R. 67:16:26:01

7 SDR 23, effective 9/18/1980; 7 SDR 66, 7 SDR 89, effective 7/1/1981; 16 SDR 226, effective 6/24/1990; 26 SDR 168, effective 7/1/2000.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.