Section 58-17C-38 - Utilization review program to use documented clinical review criteria--Criteria to be made available to authorized agencies upon request. - South Dakota Statutes

58-17C-38. Utilization review program to use documented clinical review criteria--Criteria to be made available to authorized agencies upon request. A utilization review program shall use documented clinical review criteria that are based on sound clinical evidence and are evaluated periodically to assure ongoing efficacy. A health carrier may develop its own clinical review criteria, or it may purchase or license clinical review criteria from qualified vendors. A health carrier shall make available its clinical review criteria upon request to authorized government agencies including the Division of Insurance and the Department of Health.

Source: SL 1999, ch 243, § 6.