# S.D. Codified Laws § 58-17H-5: Health carrier to provide emergency services coverage without requiring prior authorization--Standards for coverage of emergency services

> South Dakota · Statutes · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-5

## Section

- **Citation:** S.D. Codified Laws § 58-17H-5
- **Heading:** Health carrier to provide emergency services coverage without requiring prior authorization--Standards for coverage of emergency services
- **Jurisdiction:** South Dakota
- **Kind:** Statutes
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** SD Code / Title 58 / Chapter 17H / Section 58-17H-5

## Text

If conducting utilization review or making a benefit determination for emergency services, a health carrier that provides benefits for services in an emergency department of a hospital shall comply with the provisions of §§ 58-17H-5 to 58-17H-13 , inclusive. A health carrier shall cover emergency services necessary to screen and stabilize a covered person and may not require prior authorization of such services if a prudent layperson would have reasonably believed that an emergency medical condition existed even if the emergency services are provided on an out of-network basis. A health carrier shall cover emergency services whether the health care provider furnishing the services is a participating provider with respect to such services. If the emergency services are provided out-of-network, the services shall be covered without imposing any administrative requirement or limitation on coverage that is more restrictive than the requirements or limitations that apply to emergency services received from network providers. Emergency services are provided out-of-network by complying with the cost sharing requirements set forth in §§ 58-17H-7 to 58-17H-10 , inclusive, and without regard to any other term or condition of coverage other than the exclusion of or coordination of benefits, an affiliation or waiting periods as permitted under section 2704 of the Public Health Service Act, as amended to January 1, 2011, or cost sharing requirements as set forth in §§ 58-17H-6 to 58-17H-10 , inclusive.

Source: SL 2011, ch 219, § 30.

## Nearby sections

- [S.D. Codified Laws § 58-17H-1 Definitions](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-1.md)
- [S.D. Codified Laws § 58-17H-2 Health benefit plan defined](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-2.md)
- [S.D. Codified Laws § 58-17H-3 Urgent care request defined](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-3.md)
- [S.D. Codified Laws § 58-17H-4 Applicability of chapter](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-4.md)
- [S.D. Codified Laws § 58-17H-5 Health carrier to provide emergency services coverage without requiring prior authorization--Standards for coverage of emergency services](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-5.md)
- [S.D. Codified Laws § 58-17H-6 In-network emergency services](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-6.md)
- [S.D. Codified Laws § 58-17H-7 Cost-sharing requirements for out-of-network emergency services](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-7.md)
- [S.D. Codified Laws § 58-17H-8 Cost-sharing requirements for covered persons--Payments to out-of-network providers](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-8.md)
- [S.D. Codified Laws § 58-17H-9 Exceptions for payments by capitated and other plans without negotiated fees](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-9.md)
- [S.D. Codified Laws § 58-17H-10 Negotiated amounts for in-network providers for a particular emergency service](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-10.md)
- [S.D. Codified Laws § 58-17H-11 General cost-sharing requirements allowed](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-11.md)
- [S.D. Codified Laws § 58-17H-12 Access to representative for post-evaluation or post-stabilization services](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-12.md)
- [S.D. Codified Laws § 58-17H-13 Health carrier may be deemed to meet emergency medical coverage requirements if met by private accrediting body](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-13.md)
- [S.D. Codified Laws § 58-17H-14 Health carrier responsibility for utilization review activities](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-14.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-5. Check the current official text before relying on it. Not legal advice.