ARTICLE 1. General

Article 1 added by Stats. 1975, Ch. 941.

§§ 1340–1345.5 · 36 sections

§ 1340 This chapter shall be known and may be cited as the Knox-Keene Health Care Service Plan Act of 1975.
§ 1341 (a) There is in state government, in the California Health and Human Services Agency, a Department of Managed Health Care that has charge of the execution of…
§ 1341.1 The director shall have his or her principal office in the City of Sacramento, and may establish branch offices in the City and County of San Francisco, in the…
§ 1341.2 In accordance with the laws governing the state civil service, the director shall employ and, with the approval of the Department of Finance, fix the…
§ 1341.3 The director shall adopt a seal bearing the inscription: “Director, Department of Managed Health Care, State of California.” The seal shall be affixed to or…
§ 1341.4 (a) In order to effectively support the Department of Managed Health Care in the administration of this law, there is hereby established in the State Treasury,…
§ 1341.45 (a) There is hereby created in the State Treasury the Managed Care Administrative Fines and Penalties Fund. (b) The fines and administrative penalties…
§ 1341.5 (a) The director, as a general rule, shall publish or make available for public inspection any information filed with or obtained by the department, unless the…
§ 1341.6 (a) The Attorney General shall render to the director opinions upon all questions of law, relating to the construction or interpretation of any law under the…
§ 1341.7 (a) Neither the director nor any of the director’s assistants, clerks, or deputies shall be interested as a director, officer, shareholder, member other than a…
§ 1341.8 The director shall have the powers of a head of a department pursuant to Chapter 2 (commencing with Section 11150) of Part 1 of Division 3 of Title 2 of the…
§ 1341.9 The director and department succeed to, and are vested with, all duties, powers, purposes, responsibilities, and jurisdiction of the Commissioner of…
§ 1341.10 The department may use the unexpended balance of funds available for use in connection with the performance of the functions of the Department of Corporations…
§ 1341.11 All officers and employees of the Department of Corporations who, on the operative date of this section, are performing any duty, power, purpose,…
§ 1341.12 The department shall have possession and control of all records, papers, offices, equipment, supplies, moneys, funds, appropriations, licenses, permits,…
§ 1341.13 All officers or employees of the department employed after the operative date of this section shall be appointed by the director.
§ 1341.14 (a) Any regulation, order, or other action, adopted, prescribed, taken, or performed by the Department of Corporations or by an officer of the Department of…
§ 1342 It is the intent and purpose of the Legislature to promote the delivery and the quality of health and medical care to the people of the State of California who…
§ 1342.2 (a) Notwithstanding any other law, a health care service plan contract that covers medical, surgical, and hospital benefits, excluding a specialized health…
§ 1342.3 (a) A health care service plan contract that covers medical, surgical, and hospital benefits, excluding a specialized health care service plan contract, shall…
§ 1342.4 (a) The Department of Managed Health Care and the Department of Insurance shall maintain a joint senior level working group to ensure clarity for health care…
§ 1342.5 The director shall consult with the Insurance Commissioner prior to adopting any regulations applicable to health care service plans subject to this chapter…
§ 1342.6 It is the intent of the Legislature to ensure that the citizens of this state receive high-quality health care coverage in the most efficient and…
§ 1342.7 (a) The Legislature finds that in enacting Sections 1367.215, 1367.25, 1367.45, 1367.51, and 1374.72, it did not intend to limit the department’s authority to…
§ 1342.71 (a) The Legislature hereby finds and declares all of the following: (1) The federal Patient Protection and Affordable Care Act, its implementing regulations…
§ 1342.73 (a) (1) With respect to an individual or group health care service plan contract subject to Section 1367.006, the copayment, coinsurance, or any other form of…
§ 1342.74 (a) (1) Notwithstanding Section 1342.71, a health care service plan shall not subject antiretroviral drugs that are medically necessary for the prevention of…
§ 1342.75 (a) Notwithstanding any other law, a group or individual health care service plan offering an outpatient prescription drug benefit shall provide coverage for…
§ 1342.8 The State Department of Health Services and the department shall coordinate, to the extent feasible, audits or surveys of physician offices required by this…
§ 1343 (a) This chapter shall apply to health care service plans and specialized health care service plan contracts as defined in subdivisions (f) and (o) of Section…
§ 1343.1 This chapter shall not apply to any program developed under the authority of Chapter 8.75 (commencing with Section 14591) of Part 3 of Division 9 of the…
§ 1343.3 (a) The director, no later than May 1, 2021, may authorize one pilot program in southern California whereby providers approved by the department may undertake…
§ 1343.5 In any proceeding under this chapter, the burden of proving an exemption or an exception from a definition is upon the person claiming it.
§ 1344 (a) The director may from time to time adopt, amend, and rescind any rules, forms, and orders that are necessary to carry out the provisions of this chapter,…
§ 1345 As used in this chapter: (a) “Advertisement” means any written or printed communication or any communication by means of recorded telephone messages or by…
§ 1345.5 (a) “Minimum essential coverage” means any of the following: (1) Coverage under any of the following government-sponsored programs: (A) The Medicare program…