Health & Safety Code §1371.36(a)
August 28, 2020 5:48 pm(a) A health care service plan shall not deny payment of a claim on the basis that the plan, medical... View more
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Valley View Home of Beaumont, Inc. v. Department of Health Services (1983) 146 Cal.App.3d 161
August 28, 2020 5:47 pm“Notwithstanding the fact that medical services for Valley View’s disabled patients were medically necessary during the periods in question, the... View more
CA Business & Professions Code §511.1(c)
August 28, 2020 5:46 pmBeginning July 1, 2000, a payor, as defined in subparagraph (B) of paragraph (3) of subdivision (d), shall do all... View more
28 CCR §1300.71(a)(8)(T)
August 28, 2020 5:45 pmAn attempt to rescind or modify an authorization for health care services after the provider renders the service in good... View more
Health & Safety Code §1371.5(c)
August 28, 2020 5:44 pm(c) The determination as to whether an enrollee reasonably believed that the medical condition was an emergency medical condition that... View more
Health & Safety Code §1371.4(b)
August 28, 2020 5:43 pm(b) A health care service plan, or its contracting medical providers, shall reimburse providers for emergency services and care provided... View more
Health & Safety Code §1317(a)
August 28, 2020 5:42 pm(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)
August 28, 2020 5:41 pmLA City Ordinance #185210 sets “legal rates to be charged by all private ambulance companies in the City of Los... View more
28 CCR §1300.71(e)(6-8)
August 28, 2020 5:40 pm(6) The plan’s contract with a claims processing organization or the capitated provider shall include provisions authorizing the plan to... View more
28 CCR §1300.71(b)(3)
August 28, 2020 5:38 pm(b)(3) If a claim is sent to the plan’s capitated provider and the plan is responsible for adjudicating the claim,... View more