Reasons for claim denial.
Effective Aug 26, 200936 SDR 27Source: 11 SDR 144, effective May 2, 1985, amended effective July 1, 1985; 19 SDR 76, effective November 23, 1992; 22 SDR 2, effective July 17, 1995; 25 SDR 69, effective November 12, 1998; transferred from § 67:19:02:07, 36 SDR 27, effective August 26, 2009. | General Authority: SDCL 28-13A-4. | Law Implemented: SDCL 28-13A-4.
The board shall deny a county's claim for reimbursement for any of the following reasons:
- (1) The county has not paid its CCPR annual assessment;
- (2) The county has not paid its supplemental CCPR fund assessment;
- (3) The county has not paid the first $20,000 for the individual for the 12-month period;
- (4) The county has not provided the evidence required under § 22:02:02:05;
- (5) The service was provided before January 1, 1985;
- (6) The service was provided before the date of county participation;
- (7) The county has not been approved as a participating county;
- (8) The request for reimbursement has been delayed and the county failed to notify the department according to § 22:02:02:03;
- (9) The claim is for an organ transplant for which the county has failed to meet the requirements of SDCL 28-13A-13;
- (10) The county failed to follow its guidelines when determining eligibility;
- (11) The county failed to pursue other third-party payment sources;
- (12) The individual was not eligible for county poor relief; or
- (13) The claim exceeds the payment limits established in § 22:02:02:08.
Source: 11 SDR 144, effective May 2, 1985, amended effective July 1, 1985; 19 SDR 76, effective November 23, 1992; 22 SDR 2, effective July 17, 1995; 25 SDR 69, effective November 12, 1998; transferred from § 67:19:02:07, 36 SDR 27, effective August 26, 2009.
General Authority: SDCL 28-13A-4.
Law Implemented: SDCL 28-13A-4.