Community transportation services are covered if the following requirements are met:

1. (1) The transportation provider is a governmental entity, secure medical transportation provider, or registered as a nonprofit organization with the South Dakota Secretary of State;
2. (2) The transportation provider is domiciled in the State of South Dakota or enrolled as a Medicaid transportation provider in the entity or organization's state of domicile;
3. (3) The entity or organization has a signed transportation provider agreement with the department to furnish nonemergency medical transportation to recipients;
4. (4) Transportation is from an eligible recipient's residence or bus stop nearest to the recipient's residence, place of work, or school, to a medical provider; between medical providers; or from a medical provider to the recipient's residence or bus stop nearest to the recipient's residence, place of work, or school. A recipient's residence does not include a hospital, penal institution, detention center, campus setting, nursing facility, an intermediate care facility for individuals with intellectual disabilities, or an institute for the treatment of an individual with a mental disease;
5. (5) Transportation is to or from medically necessary examinations or treatment, if the services are covered under article 67:16 and are provided by a provider who is enrolled or eligible for enrollment in the medical assistance program; and
6. (6) Transportation is to the closest facility or medical provider capable of providing the necessary services, unless the recipient has a written referral or a written authorization from a medical provider in the recipient's medical community.

Source: 16 SDR 234, effective July 1, 1990; 17 SDR 201, effective July 1, 1991; 20 SDR 126, effective February 10, 1994; 25 SDR 69, effective November 12, 1998; 26 SDR 157, effective June 7, 2000; 35 SDR 253, effective May 12, 2009; 40 SDR 122, effective January 8, 2014 ; 44 SDR 94, effective December 4, 2017; 45 SDR 82, effective December 10, 2018 ; 48 SDR 39, effective October 3, 2021 .

General Authority: SDCL 28-6-1 (1)(2).

Law Implemented: SDCL 28-6-1 .

Prior versions effective: 2018-12-10, 2017-12-04, 2014-01-08.