South Dakota Administrative Rules
Title 67 - Department of Social Services
Article 67:16 - Covered medical services
Chapter 67:16:26 - Third-party liability
Section 67:16:26:01 - Definitions

(1) "Private health insurance," medical or hospital insurance coverage with benefits payable to or in behalf of an eligible recipient;

(2) "Probable existence of third-party liability," an indication in the individual's case record which suggests that a possible third-party resource exists which may be liable for the individual's medical expenses, or the identification of a third-party resource with a reasonable expectation that the third-party resource will pay on the claim; and

(3) "Third-party liability" or "third-party payment source," the obligation of an entity other than the medical assistance program for either partial or full payment of the medical cost of injury, disease, or disability. Third-party liability sources include coverage such as Medicare, private health insurance, worker's compensation, disability insurance, and automobile insurance.