The Primary Care Provider Program (PCP) is designed to improve access to medical care for Medicaid recipients as well as improve the quality of care they receive by giving them a medical home.
The majority of recipients who qualify for Medicaid are required to participate in the Primary Care Provider Program. Recipients either choose or are assigned a Primary Care Provider (PCP). This allows the recipient and their physician to develop a relationship in which the best medical care can be provided. You can also view an online provider list.
As a primary care provider program recipient, you are required to receive non-emergent primary care provider services from your Primary Care Provider (PCP). You are also required to have a referral (permission) from your PCP for non-emergent specialty and hospital services. You can receive certain services called Primary Care Provider Program Exempt Services from other providers without a referral from your PCP.
If you have any questions please contact Medical Services at 605.773.3495 or Medical@state.sd.us. You may also contact your local office for assistance.