ARSD 20:06:55:36. Exchange network adequacy standards

A qualified health plan issuer must ensure that the provider network of each qualified health plan meets the standards specified in SDCL chapter 58-17F. A qualified health plan in an Exchange may contract with any essential community provider. The service area of a qualified health plan is subject to the approval of the director and must cover a minimum geographical area that is at least the entire geographic area of a county, or a group of counties defined by the director. The service area of a qualified health plan must be established without regard to racial, ethnic, language, health status-related factors or other factors that exclude specific high utilizing, high cost or medically-underserved populations.