28-13-27.1. Medically necessary hospital services.Medically necessary hospital services are services provided in a hospital which meet the following criteria:(1)Are consistent with the person's symptoms, diagnosis, condition, or injury;(2)Are recognized as the prevailing standard and are consistent with generally accepted professional medical standards of the provider's peer group;(3)Are provided in response to a life-threatening condition; to treat pain, injury, illness, or infection; to treat a condition which would result in physical or mental disability; or to achieve a level of physical or mental function consistent with prevailing standards for the diagnosis or condition;(4)Are not furnished primarily for the convenience of the person or the provider; and(5)There is no other equally effective course of treatment available or suitable for the person needing the services which is more conservative or substantially less costly.A county shall rely on the attending physician's determination as to medical necessity of hospital services unless evidence exists to the contrary. Source: SL 1997, ch 170, §5.
South Dakota Legal Code