67 : 16 : 48 : 08 . Treatment for a substance use disorder -- Out-of-state. Out-of-state treatment for a substance use disorder is limited to those services provided in a facility which is licensed or accredited in another state as a substance use disorder treatment facility. Treatment is covered if the following additional requirements are met:

1. (1) An addiction counselor within that state completes an integrated assessment and sends the completed assessment to the division. The assessment must include a biopsychosocial history with appropriate testing instrument scores, indicate a diagnosis of a substance use disorder, and contain the credentials of the counselor completing the assessment;
2. (2) For intensive inpatient treatment or psychiatric residential treatment, a physician or other licensed practitioner refers the recipient for placement in, transfer to, or continued stay in a substance use disorder treatment program;
3. (3) The division authorizes the treatment, and no appropriate in-state treatment is available; and

4. (4) The psychiatric residential treatment provided meets the prior authorization requirements found in § 67:16:48:06.

   Out-of-state outpatient services do not require prior authorization when provided within 50 miles of the South Dakota border.

Source: 43 SDR 80 , effective December 5, 2016 ; 44 SDR 94, effective December 4, 2017; 44 SDR 192, effective July 2, 2018.

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

Law Implemented: SDCL 28-6-1 (1)(2) .

Prior versions effective: 2017-12-04, 2016-12-05.