Each contracted Center of Excellence and each contracted network of a Center of Excellence must be included in a health carrier's access plan. For purposes of network adequacy pursuant to §§ 58-17F-5 to 58-17F-9, inclusive, the health carrier's entire Center of Excellence network including both direct contracted Centers of Excellence and contracted networks shall be considered. A health carrier may not contract with a Center of Excellence network or any other network that is not registered pursuant to § 58-17F-16. Nothing in this section affects the ability of carriers to select network providers as permitted by SDCL subdivision 58-17F-11(3). For purposes of this section a Center of Excellence means a provider of transplant services that is medically recognized as having special expertise to perform a particular transplant or transplants. Transplant providers that separately contract with a health carrier do not constitute a network pursuant to this section.

Source: 36 SDR 96, effective December 9, 2009; 37 SDR 241, effective July 1, 2011.

General Authority: SDCL 58-17F-10 , 58-17F-21(4)(5).

Law Implemented: SDCL 58-17F-5 , 58-17F-6 , 58-17F-7 , 58-17F-8 , 58-17F-9.