If a medical benefit is paid in error because of a mistake made by the department, the medical benefit paid in error is not subject to recovery. Instances of department error include items such as the following:

1. (1) The department failed to take prompt action on a change reported by the individual or the individual's authorized representative;
2. (2) The department incorrectly computed the individual's income, resources, or deductions; or
3. (3) The department continued to provide the individual with medical benefits during the time the department was redetermining the individual's eligibility.

Source: 25 SDR 141, effective May 20, 1999.

General Authority: SDCL 28-6-1(4).

Law Implemented: SDCL 28-6-1(4).