S.D. Admin. R. 67:16:40:02

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

Section 67:16:40:02 - Certain hospitals required to participate in care management

An acute care hospital which is a participating provider in the medical assistance program and has a unit which is exempt from the DRG basis of reimbursement provisions must participate in care management. Units exempt from the DRG provisions include the following:

(1) A rehabilitation unit;

(2) A psychiatric unit;

(3) A neonatal unit; and

(4) A long-term care hospital unit.

An out-of-state rehabilitation hospital and an out-of-state acute care hospital is subject to the conditions of this chapter if it admits an individual from South Dakota to any of the units listed in this section and if that individual is required to participate in care management under § 67:16:40:03.

S.D. Admin. R. 67:16:40:02

21 SDR 123, effective 1/19/1995; 26 SDR 168, effective 7/1/2000; 31 SDR 39, effective 9/29/2004.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.

Certain in-state hospitals, hospital units, and procedures exempt from DRG basis of reimbursement, § 67:16:03:06.02.