S.D. Admin. R. 67:16:44:06

Current through Register Vol. 51, page 57, November 12, 2024
Section 67:16:44:06 - Rate of payment

Payment is made at an all-inclusive rate for each visit for covered services. The department follows the standards established by the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act (BIPA) of 2000, Title II, § 702 (114 Stat. 2763A-572), as amended to July 1, 2019, to determine a facility's rate of payment.

In the absence of specific regulations relating to allowable costs, the department bases allowable cost decisions on the Medicare Provider Reimbursement Manual (CMS Pub. 15-1), as specified in § 67:16:04:62.

Covered services that are not reimbursed as part of the all-inclusive rate will be reimbursed at the applicable medical assistance reimbursement methodology for the service.

S.D. Admin. R. 67:16:44:06

23 SDR 109, effective 1/5/1997; 33 SDR 44, effective 9/20/2006; 40 SDR 122, effective 1/7/2014; 46 SDR 050, effective 10/10/2019

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

Law Implemented: SDCL 28-6-1(2).

Definition of rural primary care hospital, SDCL 34-12-1.1.