Service restrictions.
Effective Oct 6, 202047 SDR 38Source: 16 SDR 111, effective January 7, 1990; 16 SDR 233, effective July 1, 1990; 18 SDR 203, effective July 1, 1992; 33 SDR 137, effective March 7, 2007; 40 SDR 122, effective January 7, 2014; 40 SDR 122, effective January 8, 2014; 47 SDR 38, effective October 6, 2020. | General Authority: SDCL 28-6-1. | Law Implemented: SDCL 28-6-1(1)(2).
Home health services must:
- (1) Be provided by a home health agency employee who is qualified to perform the required service;
- (2) Be prescribed by the attending physician or other licensed practitioner and contained in the home health agency's written plan of care;
- (3) Be provided at the individual's place of residence, which does not include a hospital, penal institution, detention center, school, nursing facility, intermediate care facility for individuals with intellectual disabilities, or an institution that treats individuals for mental diseases; and
(4) Be provided intermittently but not more than once a day and no more frequently than five days a week, except as specified by subdivision 67:16:05:05(4).
If Medicare denies payment for a service because there is no medical necessity, the individual is ineligible for services under this chapter.
Source: 16 SDR 111, effective January 7, 1990; 16 SDR 233, effective July 1, 1990; 18 SDR 203, effective July 1, 1992; 33 SDR 137, effective March 7, 2007; 40 SDR 122, effective January 7, 2014; 40 SDR 122, effective January 8, 2014; 47 SDR 38, effective October 6, 2020.
General Authority: SDCL 28-6-1.
Law Implemented: SDCL 28-6-1(1)(2).
Prior versions effective: 2014-01-08.