South Dakota Administrative Rules
Title 67 - Department of Social Services
Article 67:16 - Covered medical services
Chapter 67:16:03 - Hospital services
Section 67:16:03:06.02 - Certain in-state hospitals, hospital units, and procedures exempt from DRG basis of reimbursement
Current through Register Vol. 51, page 43, September 23, 2024
In-state freestanding rehabilitation hospitals, public health service hospitals, acute care hospitals with less than 30 Medicaid discharges during their fiscal year ending after June 30, 1996, and before July 1, 1997, and the South Dakota Children's Care Hospital are exempt from DRG reimbursement provisions. The department may exempt in-state intensive care nursery units from DRG reimbursements on request by the hospital if all costs and statistics relating to the operation of the unit are identifiable and if the unit meets the following criteria:
(1) Can provide care for infants under 750 grams;
(2) Can provide care for infants on ventilators;
(3) Can provide major surgery for newborns;
(4) Has 24-hour coverage by a neonatologist; and
(5) Has a maternal neonatology transport team.
The department may exempt a psychiatric unit and a rehabilitation unit from DRG reimbursements on request by the hospital if all costs and statistics relating to the operation of the particular unit are identifiable.
General Authority: SDCL 28-6-1.
Law Implemented: SDCL 28-6-1.
Reimbursement for DRG-exempt hospitals and units, § 67:16:03:06.06.
