Cal. Code Regs. tit. 22, § 53926
Problem Resolution Process for Members.
Effective Mar 11, 1994Register 94, No. 15Authority cited: Sections 10725, 14089.7, 14105, 14124.5, 14203 and 14312, Welfare and Institutions Code. Reference: Sections 10950, 14089, 14089.2 and 14450, Welfare and Institutions Code.State of California
- (a) Any member may request assistance from the GMC enrollment contractor in resolving problems associated with mandatory participation in the GMC program, assignment to a GMC plan, enrollment, or disenrollment.
- (b) The request for assistance from the GMC enrollment contractor shall be in writing and shall state the nature of a problem.
- (c) The GMC enrollment contractor shall prepare a written response and mail it to the member within ten days of receipt of a member's written request for problem resolution.
(d) In the event a member is dissatisfied with the response of the GMC enrollment contractor to a request for problem resolution, the member may file an appeal with the department.
- (1) The member shall submit to the department the information specified in (b) and the written response of the GMC enrollment contractor.
- (2) The department shall prepare a written decision and mail it to the member within ten days of receipt of a member's appeal.
- (e) Each member has the right to request a fair hearing, in accordance with Section 50951.
Note: Authority cited: Sections 10725, 14089.7, 14105, 14124.5, 14203 and 14312, Welfare and Institutions Code. Reference: Sections 10950, 14089, 14089.2 and 14450, Welfare and Institutions Code.
History
1. New section filed 3-11-94; operative 3-11-94; Submitted to OAL for printing only pursuant to section 147, SB 485 (Chapter 722, Statutes of 1992) (Register 94, No. 15).