{"data":{"id":"us-sd/sdcl-58-17h-42","jurisdiction":"us-sd","citation":"SDCL § 58-17H-42","heading":"Insufficient information for determination of prospective urgent care requests.","body":"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:\n(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\n(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.\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Note: SL 2012, ch 239, § 1 provides: \"The provisions of chapter 219 of the 2011 Session Laws shall be deemed repealed if the Patient Protection and Affordable Care Act, Pub.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-42","current_through":"2026-08-31","vintage":"","retrieved_at":"2026-09-03T15:18:57Z","sha256":"22904fb24eec7fd53b46f218079794bd33e4b299222a2ef070ead118402a1c67","source_id":"us-sd","stale":true,"prev":"us-sd/sdcl-58-17h-41","next":"us-sd/sdcl-58-17h-43"},"notice":"GroundRules: Original legal text. Not legal advice."}