58-17D-4. Utilization review to be administered by qualified professional.
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/sd/title-58/chapter-58-17/58-17d-4·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Any utilization review pursuant to this chapter shall be administered by a qualified licensed health care professional. Any adverse determination shall be evaluated by an appropriately licensed and clinically qualified health care professional. Any utilization review evaluation shall use generally accepted standards for treatment of the illness, injury, or condition reviewed. Any utilization review opinion shall be signed by the professional who performed the review.