Cal. Code Regs. tit. 9, § 1850.515
Department's Responsibility for Review of Disputes.
Effective Jun 18, 2006Register 2015, No. 35Authority cited: Sections 10725, 14680 and 14700, Welfare and Institutions Code. Reference: Sections 14681, 14683, 14684, 14718 and 14721, Welfare and Institutions Code.State of California
- (a) The Department shall designate at least one and no more than two individuals to review the dispute and make a joint recommendation to the Director of the Department or his/her designee(s).
- (b) The recommendation shall be based on a review of the submitted documentation in relation to the statutory, regulatory and contractual obligations of the MHP and the Medi-Cal Managed Care Plan.
- (c) The individuals reviewing the dispute may, at their discretion, allow representatives of both the MHP and the Medi-Cal Managed Care Plan an opportunity to present oral argument.
Note: Authority cited: Sections 10725, 14680 and 14700, Welfare and Institutions Code. Reference: Sections 14681, 14683, 14684, 14718 and 14721, Welfare and Institutions Code.
History
1. New section filed 5-19-2006; operative 6-18-2006 (Register 2006, No. 20).
2. Change without regulatory effect amending section heading, subsection (a) and Note filed 8-24-2015 pursuant to section 100, title 1, California Code of Regulations (Register 2015, No. 35).