South Dakota § 58-17H-42 Insufficient information for determination of prospective urgent care requests.

South Dakota Statutes

§ 58-17H-42 — Insufficient information for determination of prospective urgent care requests.

South Dakota § 58-17H-42

Title 58INSURANCE

Ch. 58-17EUTILIZATION REVIEW AND BENEFIT DETERMINATIONS

This text of South Dakota § 58-17H-42 (Insufficient information for determination of prospective urgent care requests.) is published on Counsel Stack Legal Research, covering South Dakota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

S.D. Codified Laws § 58-17H-42 (2026).

Text

If the benefit request involves a prospective review urgent care request, the provisions of § 58-17H-41 apply only in the case of a failure that:

(1)Is a communication by a covered person or, if applicable, the covered person's authorized representative, that is received by a person or organizational unit of the health carrier responsible for handling benefit matters; and (2) Is a communication that refers to a specific covered person, a specific medical condition or symptom, and a specific health care service, treatment, or provider for which approval is being requested. Commission Note:

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If the benefit request involves a prospective review urgent care request, the provisions of § 58-17H-41 apply only in the case of a failure that: (1) Is a communication by a covered person or, if applicable, the covered person's authorized representative, that is received by a person or organizational unit of the health carrier responsible for handling benefit matters; and (2) Is a communication that refers to a specific covered person, a specific medical condition or symptom, and a specific health care service, treatment, or provider for which approval is being requested. Commission Note: