S.D. Admin. R. 67:16:48:08

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

Section 67:16:48:08 - Treatment for a substance use disorder - Out-of-state

Out-of-state treatment for a substance use disorder is limited to those services provided in a facility which is licensed or accredited in another state as a substance use disorder treatment facility. Treatment is covered if the following additional requirements are met:

(1) An addiction counselor within that state completes an integrated assessment and sends the completed assessment to the division. The assessment must include a biopsychosocial history with appropriate testing instrument scores, indicate a diagnosis of a substance use disorder, and contain the credentials of the counselor completing the assessment;

(2) For intensive inpatient treatment or psychiatric residential treatment, a physician or other licensed practitioner refers the recipient for placement in, transfer to, or continued stay in a substance use disorder treatment program;

(3) The division authorizes the treatment, and no appropriate in-state treatment is available; and

(4) The psychiatric residential treatment provided meets the prior authorization requirements found in § 67:16:48:06.

Out-of-state outpatient services do not require prior authorization when provided within 50 miles of the South Dakota border.

S.D. Admin. R. 67:16:48:08

43 SDR 80, effective 12/5/2016; 44 SDR 94, effective 12/4/2017; 44 SDR 192, effective 7/2/2018

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

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