CHAPTER 2. Medi-Cal Access Program [15810. - 15849.]

Heading of Chapter 2 amended by Stats. 2014, Ch. 31, Sec. 65.

§§ 15810–15849 · 29 sections

§ 15810 (a) This chapter, formerly known as the AIM-Linked Infants Program, shall be known, and may be cited, as the Medi-Cal Access Program. (b) This section shall…
§ 15811 (a) The definitions contained in this section govern the construction of this chapter, unless the context requires otherwise. (b) “Access-linked infant” means…
§ 15814 (a) The department, in coordination with the California Tobacco Control Program of the State Department of Public Health, shall develop protocols relating to…
§ 15818 (a) Each participating health plan contracting with the department pursuant to this chapter shall provide health education services related to tobacco use to…
§ 15822 Health care services under the program shall include, but are not limited to, all of the following: (a) Preventive, screening, diagnostic, and treatment…
§ 15824 To the extent permitted by federal law, services for individuals eligible under this chapter shall be provided, at the department’s discretion and to the…
§ 15826 (a) The department shall administer the program and may do all of the following: (1) Determine eligibility criteria for the program. These criteria shall…
§ 15827 (a) The department shall administer the program in a manner that ensures that program expenditures do not exceed amounts available in the fund. (b) This…
§ 15828 The department shall coordinate with other state agencies, as appropriate, to help ensure continuity of health care services.
§ 15830 (a) The department may contract with a variety of health plans and types of health care service delivery systems in order to offer subscribers a choice of…
§ 15832 (a) To be eligible to participate in the program, a person shall meet all of the requirements in either paragraph (1) or (2): (1) (A) Be pregnant or in the… see note
§ 15833 (a) A person eligible pursuant to paragraph (1) of subdivision (a) of Section 15832 shall not be eligible to participate in the program if, at the time of…
§ 15834 A person shall not be eligible for covered services under the program if those services are covered through private health care coverage arrangements at the…
§ 15835 (a) Subscribers enrolled pursuant to paragraph (1) of subdivision (a) of Section 15832 shall not be disenrolled for failure to pay subscriber contributions.…
§ 15836 (a) If a subscriber is dissatisfied with any action, or failure to act, that has occurred in connection with eligibility or covered services under this…
§ 15838 (a) A provider who is furnished documentation of a subscriber’s enrollment in the program shall not seek reimbursement or attempt to obtain payment for any…
§ 15839 (a) Services that would be covered under the program that are provided to pregnant women who, after receiving those services, are subsequently determined to be…
§ 15840 (a) (1) At a minimum, coverage provided pursuant to this chapter shall be provided to subscribers during one pregnancy, and until the end of the month in which… see note
§ 15841 (a) Through its courts, statutes, and under its Constitution, California protects a woman’s right to reproductive privacy. California reaffirms these…
§ 15842 Notwithstanding any other law, for a subscriber who is determined by the California Children’s Services Program to be eligible for benefits under the program…
§ 15844 A child enrolled in the program under this chapter who has a medical condition that is eligible for services pursuant to the California Children’s Services…
§ 15846 The department shall encourage all providers who provide services under the program to have viable protocols for screening and referring children needing…
§ 15847 (a) It shall constitute unfair competition for purposes of Chapter 5 (commencing with Section 17200) of Part 2 of Division 7 of the Business and Professions…
§ 15847.3 (a) It shall constitute an unfair labor practice contrary to public policy, and enforceable under Section 95 of the Labor Code, for any employer to refer an…
§ 15847.5 (a) It shall constitute an unfair labor practice contrary to public policy and enforceable under Section 95 of the Labor Code for any employer to change the…
§ 15847.7 (a) For purposes of Sections 15847, 15847.3, and 15847.5, “group health coverage” includes any health care service plan, self-insured employee welfare benefit…
§ 15848 (a) The Perinatal Insurance Fund is continued in existence in the State Treasury under the administration of the department. (b) Amounts deposited in the fund…
§ 15848.5 (a) The department shall authorize the expenditure of money in the fund to cover program expenses, including program expenses that exceed subscriber…
§ 15849 (a) Effective July 1, 2022, to the extent allowable under federal law, notwithstanding the provisions of this chapter to the contrary, the department may elect…