{"code":"HSC","codeName":"Health and Safety Code","section":"1371.36","citation":"Health & Saf. Code, § 1371.36","status":"in-force","lawOn":"2026-09-28","headings":[{"name":"DIVISION 2. LICENSING PROVISIONS [1200. - 1796.88.]","url":"https://blackletter.si/health-and-safety-code/division-2"},{"name":"CHAPTER 2.2. Health Care Service Plans [1340. - 1399.874.]","url":"https://blackletter.si/health-and-safety-code/division-2/chapter-2.2"},{"name":"ARTICLE 5. Standards [1367. - 1374.198.]","url":"https://blackletter.si/health-and-safety-code/division-2/chapter-2.2/article-5"}],"history":"Added by Stats. 2000, Ch. 827, Sec. 5.   Effective January 1, 2001.","effective":"2001-01-01","html":"<p>(a) A health care service plan shall not deny payment of a claim on the basis that the plan, medical group, independent practice association, or other contracting entity did not provide authorization for health care services that were provided in a licensed acute care hospital and that were related to services that were previously authorized, if all of the following conditions are met: </p><p>(1) It was medically necessary to provide the services at the time. </p><p>(2) The services were provided after the plan’s normal business hours. </p><p>(3) The plan does not maintain a system that provides for the availability of a plan representative or an alternative means of contact through an electronic system, including voicemail or electronic mail, whereby the plan can respond to a request for authorization within 30 minutes of the time that a request was made. </p><p>(b) This section shall not apply to investigational or experimental therapies, or other noncovered services. </p>","text":"(a) A health care service plan shall not deny payment of a claim on the basis that the plan, medical group, independent practice association, or other contracting entity did not provide authorization for health care services that were provided in a licensed acute care hospital and that were related to services that were previously authorized, if all of the following conditions are met: (1) It was medically necessary to provide the services at the time. (2) The services were provided after the plan’s normal business hours. (3) The plan does not maintain a system that provides for the availability of a plan representative or an alternative means of contact through an electronic system, including voicemail or electronic mail, whereby the plan can respond to a request for authorization within 30 minutes of the time that a request was made. (b) This section shall not apply to investigational or experimental therapies, or other noncovered services.","otherVersions":[],"url":"https://blackletter.si/health-and-safety-code/standards-1371-36","source":"California Legislative Information bulk export (pubinfo)"}