Private Insurance Data Requirements in South Dakota
Private Insurance Data Requirements in South Dakota
| Subtopic | Statute/Regulation | Description |
|---|
| Disclosure of information held by health plan, including notice requirements | Confidential data -- Exceptions, SDLC § 58-41-74 | Confidential data -- Exceptions Classifies the HMO enrollee health information as confidential. Prohibits disclosure unless the individual... |
| Preexisting condition information: How the insurer may use preexisting condition information | Genetic information use in setting premiums, S.D. Admin. R. 20:06:39:44 | Prohibition on genetic information in setting premium rates. Prohibits carriers for individual health insurance from adjusting premium... |
| Research exception, S.D. Admin. R. 20:06:39:44 | Research exception Prohibits carriers of individual coverage from requiring genetic testing, but permits carriers to request testing for... | |
| Use of genetic information, S.D. Admin. R. 20:06:13:89 | Use of genetic information Prohibits Medicare supplement carriers from using genetic information to deny coverage or adjust premium... |
| Preexisting condition information: Requirements about what type of information the insurer can collect | Prohibition on genetic information as preexisting condition, S.D. Admin. R. 20:06:39:53 | Prohibition on genetic information as preexisting condition Prohibits carriers of individual health coverage from using genetic information to... |
| Underwriting prohibitions, S.D. Admin. R. 20:06:39:48 | Prohibitions on collection of genetic information for underwriting purposes. Prohibits carriers of individual health coverage from... | |
| Use of genetic information, S.D. Admin. R. 20:06:13:89 | Use of genetic information Prohibits Medicare supplement carriers from using genetic information to deny coverage or adjust premium... |
| Health plan required reporting | Record keeping, S.D. Admin. R. 20:06:53:76 | Record keeping Requires health carriers to maintain records of claims and appeals and to permit inspection of these records by the... |
| Requirements of quality improvement activities, SDLC § 58-17G-4 | Health carrier issuing closed plan to develop quality improvement activities -- Minimum requirements of quality improvement activities. ... | |
| Review procedures and authorization to accompany notice, S.D. Admin. R. 20:06:53:05 | Review procedures and authorization to accompany notice Requires health carriers to describe their standard and external review procedures... | |
| Systems to measure quality of services, SDLC § 58-17G-3 | Health Carrier to develop and maintain systems to measure quality of services -- System requirements -- Description of quality assessment program to... |
| Grievance procedures | Record keeping, S.D. Admin. R. 20:06:53:76 | Record keeping Requires health carriers to maintain records of claims and appeals and to permit inspection of these records by the... |
| Required testing by insurance company(genetic and HIV/STD) | Requirement of genetic testing, S.D. Admin. R. 20:06:13:91 | Requirement of genetic testing Prohibits Medicare supplement carriers from requiring genetic testing, but permits carriers to request... |
| Research exception, S.D. Admin. R. 20:06:40:34 | Research exception Prohibits employer plans from requiring genetic testing, but permits plans to request testing for research purposes... |
| Other | Rules to protect privacy of medical records, SDLC § 58-2-40 | Promulgation of rules to protect privacy of medical records Requires the Director of Insurance to establish rules for protecting the privacy... |
| Cost reporting by insurance companies (Cross reference Provider Resource Use) | Statistical reports, S.D. Admin. R. 44:18:01:04 | Statistical reports Identifies seven statistics that HMOs must annually report to the Director of Insurance (e.g., cost statistics,... |
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