Rule 20:06:21:73 Providers in a different state.
20:06:21:73. Providers in a different state. No long-term
care issuer may deny a claim because services are provided in a state other
than the state of policy issue if the following conditions are met:
(1) If the state other than
the state of policy issue does not have the provider licensing, certification,
or registration required in the policy, but the provider satisfies the policy
requirements outlined for providers in lieu of licensure, certification, or
(2) If the state other than
the state of policy issue licenses, certifies, or registers the provider under
For purposes of this section,
"state of policy issue" means the state in which the individual
policy or certificate was originally issued.
33 SDR 230, effective July 2, 2007.
Authority: SDCL 58-17B-4.
Implemented: SDCL 58-17B-4.
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