S.D. Admin. R. 67:16:49:02

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

Section 67:16:49:02 - Travel requirements

Travel services must meet the following requirements:

(1) Travel is from an eligible recipient's city of residence to a medical provider located in another city, between medical providers located in different cities, or from a medical provider located in one city to the recipient's city of residence. If the recipient's city of residence does not have a commercial carrier or if a commercial carrier located in another city is less costly, the department shall pay the recipient's travel expenses from the recipient's city of residence to the commercial carrier under provisions of § 67:16:49:03;

(2) Travel is to or from medically necessary examinations or treatment when the services are covered under article 67:16 or chapter 67:46:10 and provided by a provider who is enrolled or eligible for enrollment in the medical assistance program; or the travel is between a medical provider and the recipient's city of residence and is for the purpose of allowing a parent or guardian to travel to visit a minor who is a recipient, in a hospital or medical facility, and receiving medically necessary services covered under article 67:16 and the travel is necessary to meet the requirements of the child's service care plan;

(3) Travel 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 the recipient's medical provider; or travel is for a visit referred to in subdivision (2) of this section; and

(4) If travel is via a commercial carrier, the department has worked with the commercial carrier to arrange the travel and prior authorized the service. Reimbursement for commercial carrier travel not arranged with the department may be reimbursed at the departments discretion.

At its discretion the department may pay for transportation services not meeting the conditions of this section if paying for the services results in an overall cost savings for the department.

S.D. Admin. R. 67:16:49:02

44 SDR 94, effective 12/4/2017

General Authority: SDCL 28-6-1.

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