Nothing in this section requires a plan or issuer that has a network of providers to provide benefits for items or services described in § 20:06:54:01 that are delivered by an out-of-network provider. Moreover, nothing in this section precludes a plan or issuer that has a network of providers from imposing cost-sharing requirements for items or services described in § 20:06:54:01 that are delivered by an out-of-network provider.

Source: 37 SDR 63, effective September 23, 2010; 37 SDR 111, effective December 7, 2010.

General Authority: SDCL 58-17-87 , 58-18-79.

Law Implemented: SDCL 58-17-1.1 , 58-17-1.2 , 58-17-62 , 58-17-87 , 58-17-98 , 58-18-36 , 58-18-41 , 58-18-79 , 58-18-80 , 58-18-83.