{"data":{"id":"us-sd/sdcl-58-17h-17","jurisdiction":"us-sd","citation":"SDCL § 58-17H-17","heading":"Utilization review program to use documented clinical review criteria--Criteria to be available to authorized agencies upon request.","body":"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.\nCommission Note: SL 2012, ch 239, § 1 provides: \"The provisions of chapter 219 of the 2011 Session Laws shall be deemed repealed if the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119 (2010), as amended by the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, 124 Stat. 1029 (2010) is found to be unconstitutional in its entirety by a final decision of a federal court of competent jurisdiction and all appeals exhausted or time for appeals elapsed.\"","path":["TITLE 58. INSURANCE","CHAPTER 58-17H. UTILIZATION REVIEW AND BENEFIT DETERMINATIONS"],"source_url":"https://sdlegislature.gov/Statutes/58-17H-17","current_through":"2026-08-31","vintage":"","retrieved_at":"2026-09-03T15:18:57Z","sha256":"ce6bf4809414fb28219cd9f9fc9fd4c0fea2f1ffea35ae8b2ffd50dbb1948152","source_id":"us-sd","stale":true,"prev":"us-sd/sdcl-58-17h-16","next":"us-sd/sdcl-58-17h-18"},"notice":"GroundRules: Original legal text. Not legal advice."}