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South Dakota Codified Laws
Title 58
Chapter 58-41
S.D. Codified Laws ch. 58-41
Health Maintenance Organizations
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58-41-1
Definition of terms.
58-41-2
Organizations subject to chapter.
58-41-3
Certificate of authority required for health maintenance organization or contracts--Violation as misdemeanor.
58-41-4
Application for certificate of authority required.
58-41-5
Repealed
Repealed
58-41-6
Verification and form of application--Contents.
58-41-7
Financial statements required with application.
58-41-8
Copies of forms required with application.
58-41-9
Marketing, charges, and financial plans required with application.
58-41-10
Appointment to receive process required of foreign applicant.
58-41-11
Surety bond or deposit required--Waiver.
58-41-12
Determination of health care qualifications.
58-41-13
Coordination with federal professional standards review.
58-41-14
Obsolete
58-41-15
Health maintenance not considered practice of healing arts.
58-41-15.1
Certain healing arts practitioners to participate in alternate health care delivery systems.
58-41-16
Repealed
Repealed
58-41-17
Issuance or denial of certificate--Fee--Conditions for issuance.
58-41-18
Factors considered in determining financial responsibility.
58-41-19
Insurance arrangements permitted.
58-41-20
Corporation operating after certification.
58-41-21
Foreign corporations qualifying--Exemption from other requirements.
58-41-22
Filing of notice of modification of operation--Approval if not disapproved--Exemptions.
58-41-23
Composition of governing body--Consumer representation.
58-41-24
Mechanisms for enrollee participation in policy and operation of governing body.
58-41-25
Fiduciary responsibilities to enrollees.
58-41-25.1
Investments.
58-41-26
Exemption from insurance laws--Exceptions--Taxation.
58-41-27
Repealed
Repealed
58-41-28
Solicitation of enrollment not deemed professional advertising.
58-41-29
Contracts and necessary activities.
58-41-29.1
Notice required for rate increase in health maintenance contract by a health maintenance organization.
58-41-30
Sources of payment for enrollee services--Application by medical assistance recipient.
58-41-31
Direct payments to enrollees prohibited.
58-41-32
Use of words descriptive of insurance, casualty, or surety business as misdemeanor--Exception.
58-41-33
Trade practice laws applicable.
58-41-34
Evidence of coverage issued to enrollees.
58-41-35
Contents required in evidence of coverage.
58-41-35.1
Alcoholism coverage to be offered at time contract is negotiated.
58-41-35.5
Grandfathered contracts required to cover low-dose mammography--Extent of coverage.
58-41-35.6
Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony.
58-41-35.7
Contracts required to cover occult breast cancer screening.
58-41-36
Unfair and misleading information in evidence of coverage as misdemeanor.
58-41-37
Deceptive advertising or evidence of coverage as misdemeanor.
58-41-38
Statements deemed untrue.
58-41-39
Statements deemed misleading.
58-41-40
Evidence of coverage deemed deceptive.
58-41-41
Issuance to enrollees of change in evidence of coverage.
58-41-42
Evidence of coverage to be approved before use--Violation as misdemeanor.
58-41-43
Filing and approval requirements applicable.
58-41-44
Charges to enrollees--Fairness--Actuary's certificate.
58-41-45
Discrimination as misdemeanor.
58-41-50
Authorized expenses.
58-41-51
Repealed
Repealed
58-41-51.1
Individual policy required for covered spouse of insured--Eligibility--Coverage--Waiting periods.
58-41-51.2
Conversion privileges of insured's spouse upon divorce.
58-41-51.3
Continuation and conversion coverage to be offered.
58-41-52
Contracts with providers of health care services.
58-41-52.1
Collection for covered services prohibited.
58-41-52.2
Contracts--Hold harmless provision.
58-41-52.3
Hold harmless provision--Language of provision.
58-41-53
Repealed
Repealed
58-41-54
Contracts with insurance companies and nonprofit health service plan corporations authorized--Limitations.
58-41-55
Insurance contracts authorized--Group coverage--Benefit payments.
58-41-56
Contracts for management and administrative services authorized.
58-41-57
Payment of unreasonably high expenses as misdemeanor.
58-41-63
General annual report required--Form and contents.
58-41-64
Repealed
Repealed
58-41-65
Applications, filings and reports as public documents.
58-41-66
Annual summary for enrollees required--Contents.
58-41-67
Promulgation of rules.
58-41-73
Physician-patient privileges.
58-41-74
Confidential data--Exceptions.
58-41-77
Repealed
Repealed
58-41-78
Cease and desist orders.
58-41-79
Hearing on cease and desist order--Procedure--Judicial review.
58-41-80
Injunctive relief against violations--Venue.
58-41-81
Suspension or revocation of certificate of authority on findings by director.
58-41-82
Additional grounds for suspension or revocation.
58-41-83
Voluntary conference before commencing actions for violation.
58-41-84
Informality in voluntary conferences.
58-41-85
Money penalty in lieu of suspension or revocation.
58-41-86
Requirements for suspension or revocation.
58-41-86.1
Suspension without notice or hearing.
58-41-87
Notice of grounds for denial, suspension, or revocation of certificate--Time of hearing--Summary proceedings excepted.
58-41-88
Administrative procedure and rules.
58-41-89
Repealed
Repealed
58-41-90
Action of director after hearing--Written findings.
58-41-91
Judicial review.
58-41-92
Activities prohibited during suspension of certificate.
58-41-93
Winding up after revocation of certificate--Continued operation to protect enrollees.
58-41-94
Summary proceeding to reorganize organization--Grounds.
58-41-95
Rehabilitation, liquidation, or conservation under insurance company laws.
58-41-96
Severability of provisions.
58-41-97
Citation of chapter.
58-41-98
Coverage for phenylketonuria.
58-41-99
Formation of voluntary health insurance purchasing organizations.
58-41-100
Membership of voluntary health insurance purchasing organizations.
58-41-101
Purchasing organization's responsibility for negotiating terms and conditions.
58-41-102
Purchasing organization's notice of premium charge.
58-41-103
Additional chapters applicable to purchasing organization.
58-41-104
Approval of purchasing organization by Division of Insurance.
58-41-105
Premiums held in trust by purchasing organization.
58-41-106
Rates for group health insurance issued to purchasing organizations.
58-41-107
Reasonable participation requirements for group members of purchasing organizations.
58-41-108
Purchasing organizations exempt from antitrust provisions.
58-41-109
Promulgation of rules for purchasing organizations.
58-41-110
Application of chapter to provider contracting with state.
58-41-111
Application of chapter to provider contracting with licensed health maintenance organization.
58-41-112
Minimum inpatient care coverage following delivery.
58-41-113
Shorter hospital stay permitted--Follow-up visit within forty-eight hours required.
58-41-114
Notice to enrollees--Disclosures.
58-41-115
Health insurance policies to provide coverage for biologically-based mental illnesses.
58-41-116
Application--Exemptions.
58-41-117
Policies to provide coverage for diabetes supplies, equipment, and education--Exceptions--Conditions and limitations.
58-41-118
Diabetes coverage not required of certain plans and policies.
58-41-119
Contracts to provide coverage for prostate cancer screening.
58-41-120
Annual report on risk bearing entities.
58-41-121
Documents provided to risk bearing entity by health maintenance organization.
58-41-122
Documents provided to health maintenance organization by risk bearing entity.
58-41-123
Notice by risk bearing entity of change in conditions--Assignment of contract.
58-41-124
Notice to director that risk bearing entity has materially failed to perform contract.
58-41-125
Confidentiality of information.
58-41-126
Nontransferable responsibilities of health maintenance organization.
58-41-127
Coverage for treatment of hearing impairment for persons under age nineteen.