“Notwithstanding the fact that medical services for Valley View’s disabled patients were medically necessary during the periods in question, the... View more
Beginning July 1, 2000, a payor, as defined in subparagraph (B) of paragraph (3) of subdivision (d), shall do all... View more
An attempt to rescind or modify an authorization for health care services after the provider renders the service in good... View more
(c) The determination as to whether an enrollee reasonably believed that the medical condition was an emergency medical condition that... View more
(b) A health care service plan, or its contracting medical providers, shall reimburse providers for emergency services and care provided... View more
(a) Emergency services and care shall be provided to any person requesting the services or care, or for whom services... View more
LA City Ordinance #185210 sets “legal rates to be charged by all private ambulance companies in the City of Los... View more
(6) The plan’s contract with a claims processing organization or the capitated provider shall include provisions authorizing the plan to... View more
(b)(3) If a claim is sent to the plan’s capitated provider and the plan is responsible for adjudicating the claim,... View more
(2) If a claim is sent to a plan that has contracted with a capitated provider that is responsible for... View more