Rule 20:06:53:24 Notifications upon request for expedited external review.
20:06:53:24. Notifications upon
request for expedited external review. Upon receipt of a request for an
expedited external review, the director immediately shall send a copy of the
request to the health carrier. Immediately upon receipt of the request from the
director, the health carrier shall determine whether the request meets the
reviewability requirements set forth in § 20:06:53:12. The health carrier
shall immediately notify the director and the covered person and, if
applicable, the covered person's authorized representative of its eligibility
notice of initial determination shall include a statement informing the covered
person and, if applicable, the covered person's authorized representative that
a health carrier's initial determination that an external review request is
ineligible for review may be appealed to the director.
Source: 37 SDR 48, effective September
22, 2010; 37 SDR 241, effective July 1, 2011.
General Authority: SDCL 58-17-87, 58-17H-49, 58-17I-16, 58-18-79.
Law Implemented: SDCL 58-17-87, 58-18-79.
Back to 20:06:53