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Proposed Administrative Rules
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Department of Labor & Regulation
Division of Labor and Management
Notice of Public Hearing to Adopt Rules
See explanation of rules changes
A public hearing was held in Conference Room 3, Kneip Building, 700 Governors Drive, Pierre, South Dakota, on October 20, 2011 at 10 a.m., to consider the adoption and amendment of proposed rules to the following:
Chapter 47:03
The effect of the rules is to update references in the workers compensation medical case management rules, revise the workers compensation fee schedule, and repeal the department's optimal recovery guidelines.
The reason for adopting these rules are to change references to the labor department to the labor and regulation department, to simplify the workers compensation fee schedule, and to eliminate outdated medical care standards for workers compensation cases.
After the hearing, the Department of Labor and Management will consider all written and oral comments it receives on the proposed rules. The Department may modify or amend a proposed rule at that time to include or exclude matters that are described in this notice.
See the Rules Text in Adobe .pdf format*. (Please note the document is 464 pages.)
Notice is further given to individuals with disabilities that this hearing was held in a physically accessible place. Please notify the Department of Labor and Management at least 48 hours before a public hearing if you have special needs for which special arrangements must be made. The telephone number for making special arrangements is 605.773.3681. Material sent by mail had to reach the Department of Labor and Management by October 20, 2011 to be considered.
Explanation of Rules Changes
On December 12, 2011, the Department's proposed worker's compensation fee schedule rules became effective. The rules were significantly reformatted, but their effect was not changed. The Appendix A and C fee schedule tables were repealed, but the reimbursements are the same as before; they are calculated by multiplying the unit value found in Relative Values for Physicians, 2011© by the corresponding conversion factor found at rule ARSD 47:03:05:05 (or 47:03:05:10.01 for anesthesia). Inpatient hospital facility charges, billed under Revenue codes, are reimbursed at either 80 percent or 100 percent of billing per ARSD 47:03:05:12. Outpatient hospital or ASC service billings are reimbursed by referring to the CPT/HCPCS service code (not the Revenue code) and applying the 47:03:05:05 methodology. As before, for dentistry, refer to ARSD 47:03:05:13, and for pharmacy, ARSD 47:05:03:14. All other charges are paid at either eighty percent or one hundred percent of billing per 47:03:05:05 or 47:03:05:12.
Please contact James Marsh at 605.773.3681 or by e-mail if you have questions.
*Opening and printing Adobe .pdf files requires Adobe Acrobat Reader. Click here as needed to download the free Adobe Acrobat Reader.
700 Governors Drive
Pierre, SD 57501-2291
Tel. 605.773.3101
Fax. 605.773.6184
