South Dakota Administrative Rules
Title 67 - Department of Social Services
Article 67:16 - Covered medical services
Chapter 67:16:11 - Early and periodic screening
Section 67:16:11:03.22 - Private duty nursing services - Extended home health aide services - Prior authorization - Reauthorization

A provider must have authorization from the department before providing either private duty nursing services or extended home health aide services. The provider must submit to the department a written plan of care which has been reviewed and signed by the attending physician. The department's authorization is based on its review of the required documentation to determine if the conditions for payment have been met. The department may verbally authorize services after the plan of care is submitted; however, the department shall verify a verbal authorization in writing before the services are paid.

An authorization may not exceed two months. The provider may request reauthorization by submitting an updated plan of care and the physician's recertification indicating the need for continued private duty nursing services or extended home health aide services.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.