ARTICLE 6.3. Medi-Cal Managed Care Plans
Article 6.3 added by Stats. 2017, Ch. 738, Sec. 7.
§§ 14197–14197.9 · 18 sections
- § 14197 (a) It is the intent of the Legislature that the department implement and monitor compliance with the time or distance requirements set forth in Sections…
- § 14197.04 (a) (1) A Medi-Cal managed care plan that has received approval from the department to utilize an alternative access standard pursuant to subdivision (f) of…
- § 14197.05 (a) As part of the federally required external quality review organization (EQRO) review of Medi-Cal managed care plans in the annual detailed technical report…
- § 14197.07 (a) A Medi-Cal managed care plan shall ensure access to care for latent tuberculosis infection and active tuberculosis disease and coordination with local…
- § 14197.08 (a) A contract between the department and a Medi-Cal managed care plan shall require the Medi-Cal managed care plan to do both of the following: (1) Identify,…
- § 14197.09 (a) (1) No later than 12 months after the working group develops its recommendations for curriculum pursuant to subdivision (b) of Section 150950 of the Health…
- § 14197.1 (a) The department shall ensure that all covered mental health benefits and substance use disorder benefits, as those terms are defined in Section 438.900 of…
- § 14197.11 (a) Notwithstanding any other law, subject to subdivisions (e) and (g), the department may enter into one or more comprehensive risk contracts with an…
- § 14197.2 (a) This section implements the state option in subsection (j) of Section 438.8 of Title 42 of the Code of Federal Regulations. (b) Commencing July 1, 2019, a…
- § 14197.3 (a) A Medi-Cal managed care plan shall give a beneficiary timely and adequate notice of an adverse benefit determination in writing consistent with the…
- § 14197.4 (a) The Legislature finds and declares all of the following: (1) Designated public hospital systems play an essential role in the Medi-Cal program, providing…
- § 14197.45 (a) Notwithstanding any other law, for covered benefits under its contract, as applicable, a Medi-Cal managed care plan shall comply with all of the following:…
- § 14197.5 (a) Notwithstanding any other law, but no sooner than July 1, 2019, the Cost-Based Reimbursement Clinic Directed Payment Program shall be in operation. (b) For…
- § 14197.6 (a) For purposes of this section, the following definitions apply: (1) “Children’s hospital” has the same meaning as that term is defined in Section 10727. (2)…
- § 14197.7 (a) (1) Notwithstanding any other law, if the director finds that an entity that contracts with the department for the delivery of health care services…
- § 14197.71 (a) The department may, at its discretion, align relevant terms of its contract with a Medi-Cal behavioral health delivery system with the terms of its…
- § 14197.8 (a) (1) As part of the health care options information posted by the department, in the provider directory that lists accepted Medi-Cal managed care plans,…
- § 14197.9 (a) To the extent permitted under federal law, the department shall require a Medi-Cal managed care plan that is not licensed by the Department of Managed…