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Article 3. Operational Requirements | Midpage
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California Code of Regulations
Title 22
Division 3. Health Care Services
Subdivision 1. California Medical Assistance Program
Chapter 4. Prepaid Health Plans
Article 3. Operational Requirements
Article 3. Operational Requirements
State of California
53200
Organization and Administration.
53210
Scope of Services.
53212
Availability of Services.
53214
Pharmaceutical Services and Prescribed Drugs.
53216
Care Under Emergency Circumstances.
53218
Preventive Health Care Services. [Repealed]
53220
Member Billing.
53222
Recovery from Other Sources.
53230
Facilities, Service Locations and Equipment.
53240
Personnel Resources. [Repealed]
53242
Providers.
53244
Allied Health Personnel. [Repealed]
53246
Medical Director.
53250
Subcontracts.
53251
Assumption of Financial Risk.
53252
Reinsurance.
53260
Grievance Procedures.
53261
Notice to Members of Plan Action to Deny, Defer or Modify a Request for Medical Services.
53270
Consumer Participation in Policy Making. [Repealed]
53280
Quality of Care.
53282
Medical Record System. [Repealed]
53284
Medical Record Service.
53286
Continuity of Care.
53288
Shared Responsibility for Members' Health Care. [Repealed]
53290
Medical Review. [Repealed]
53291
General Reviews. [Repealed]
53310
Records.
53312
Reporting.
53314
Statistical Data.
53320
Capitation Payment.
53321
Capitation Payment Rates Determination.
53322
Capitation Rate Redetermination.
53323
Cost Reimbursement. [Repealed]
53324
Financial Resources.
53326
Financial Security.
53330
Affiliate.
53340
Financial Audit.
53350
Civil Penalties.
53352
Contract Termination.