ARTICLE 2.9. Primary Care Provider Case Management
Article 2.9 added by Stats. 1982, Ch. 328, Sec. 20.
§§ 14088–14088.25 · 20 sections
- § 14088 (a) The purpose of this article is to ensure that the Medi-Cal program shall be operated in the most cost-effective and efficient manner possible with the…
- § 14088.05 For purposes of this article, “primary care case management plan” means a primary care provider or other entity who has contracted with the department pursuant…
- § 14088.2 The primary care provider or other entity eligible pursuant to this article with whom a contract has been entered into pursuant to this article shall have…
- § 14088.4 (a) No reimbursement shall be provided, for any beneficiary receiving case management services, for any services covered by the contract entered into pursuant…
- § 14088.5 The beneficiary shall be permitted to disenroll from any contract entered into pursuant to this article upon request, except where prohibited under the…
- § 14088.6 In order to achieve maximum cost savings, the Legislature hereby determines that an expedited contract process for contracts under this article is necessary.…
- § 14088.7 Primary care providers and other entities with whom a contract has been entered into pursuant to this article shall be exempt from Chapter 2.2 (commencing with…
- § 14088.8 (a) The department may establish modified primary care case management contracts pursuant to this article. This authority shall be subject to the department…
- § 14088.85 (a) The department may enter into primary care case management contracts with primary care providers that serve persons infected with human immunodeficiency…
- § 14088.12 Primary care case management contractors shall establish, maintain, and conduct an active, ongoing outreach and recruitment effort to add primary care and…
- § 14088.13 The department shall approve those Medi-Cal services for which the contractor is at risk that shall be provided in any contract or contracts for services under…
- § 14088.14 The department may enter into contracts pursuant to this article with nurse practitioners, acting within the scope of practice of a nurse practitioner,…
- § 14088.15 A plan shall not use false advertising or false statements to induce enrollment. No solicitation of enrollees shall include the granting or offering of any…
- § 14088.16 The department or a county which has contracted for the provision of services pursuant to this article may, within service areas designated by the department,…
- § 14088.17 (a) The department may contract under this article, on an exclusive or nonexclusive basis, with an established professional organization with a membership…
- § 14088.18 (a) In order to increase the number of nonprofit providers under this article, the department may enter into contracts each fiscal year under this section with…
- § 14088.19 (a) The department may enter into primary care case management contracts pursuant to this article with any health care service plan that is licensed by the…
- § 14088.22 Sections 14408, 14409, 14410, and 14411 shall apply to primary care case management plans.
- § 14088.23 (a) The department may apply one or more of the following sanctions against any contractor for failure to comply with the requirements of this article,…
- § 14088.25 (a) The department may conduct onsite reviews of a provider or facility that has agreed with the primary care case management contractor or a potential…