South Dakota Statutes

§ 58-17H-17 — Utilization review program to use documented clinical review criteria--Criteria to be available to authorized agencies upon request.

South Dakota·Title 58 INSURANCE·Ch. 58-17E UTILIZATION REVIEW AND BENEFIT DETERMINATIONS
A utilization review program shall use documented clinical review criteria that are based on sound clinical evidence and are evaluated periodically to assure ongoing efficacy. A health carrier may develop its own clinical review criteria, or it may purchase or license clinical review criteria from qualified vendors. A health carrier shall make available its clinical review criteria upon request to authorized government agencies including the Division of Insurance and the Department of Health. Commission Note:

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South Dakota § 58-17H-17 (Utilization review program to use documented clinical review criteria--Criteria to be available to authorized agencies upon request.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Legislative History

SL 2011, ch 219, § 42.

Nearby Sections

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