{"data":{"id":"us-sd/sdcl-58-17h-49","jurisdiction":"us-sd","citation":"SDCL § 58-17H-49","heading":"Promulgation of rules.","body":"The director may, after consultation with the secretary, promulgate rules, pursuant to chapter 1-26, to carry out the provisions of this chapter. The rules shall provide for a timely administration of utilization review by the public and assure that utilization review decisions are made in a fair and clinically acceptable manner. The rules may include the following:\n(1) Definition of terms;\n(2) Timing, form, and content of reports;\n(3) Application of clinical criteria as it relates to utilization review;\n(4) Written determinations; and\n(5) Utilization review procedures.\nThe director may promulgate rules, pursuant to chapter 1-26, pertaining to claims for group disability income plans. The rules shall be consistent with applicable federal requirements included in 29 CFR Part 2560 as amended to January 1, 2011.\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Note: SL 2012, ch 239, § 1 provides: \"The provisions of chapter 219 of the 2011 Session Laws shall be deemed repealed if the Patient Protection and Affordable Care Act, Pub.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-49","current_through":"2026-08-31","vintage":"","retrieved_at":"2026-09-03T15:18:57Z","sha256":"4461ad9389f9963b88fdda194458b8c5e3c43f79045fea10f5c58bc26b49ad03","source_id":"us-sd","stale":true,"prev":"us-sd/sdcl-58-17h-48","next":"us-sd/sdcl-58-17h-50"},"notice":"GroundRules: Original legal text. Not legal advice."}