S.D. Codified Laws ch. 58-17I – Grievance Procedure | Midpage

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South Dakota Codified Laws

Chapter 58-17I

S.D. Codified Laws ch. 58-17I

Grievance Procedure

58-17I-1Definitions.58-17I-2Health benefit plan defined.58-17I-3Urgent care request defined.58-17I-4Register of grievances required--Information to be compiled--Maintenance.58-17I-6Grievance procedures--Filing--Certificate of compliance--Contact information.58-17I-7Review of adverse determination--Time for filing--Designation and notice of reviewers--Scope of review.58-17I-8Rights of covered person or authorized representative on review--Access to documentation.58-17I-9Time for decision and notice--Calculation of time periods.58-17I-10Procedures for providing new or additional evidence.58-17I-11Issuance of decision--Required contents.58-17I-12Expedited review for adverse determinations involving urgent care requests--Appointment of peers for review.58-17I-13Transmission of necessary information for certain expedited reviews.58-17I-14Expedited review decision not initial determination for benefits--Notification--Time periods--Continuation of service involving concurrent review urgent care requests.58-17I-15Expedited review decision--Notification--Required contents.58-17I-16Promulgation of rules.