California § 1367.015. 1367.015. (Added by Stats. 2008, Ch. 722, Sec. 1.)

California Statutes

§ 1367.015. — 1367.015. (Added by Stats. 2008, Ch. 722, Sec. 1.)

California·Code HSC Health and Safety Code - HSC·Div. 2. DIVISION 2. LICENSING PROVISIONS·Ch. 2.2. CHAPTER 2.2. Health Care Service Plans·Art. 5. ARTICLE 5. Standards

In addition to complying with subdivision (h) of Section 1367.01, in determining whether to approve, modify, or deny requests by providers prior to, retrospectively, or concurrent with the provision of health care services to enrollees, based in whole or in part on medical necessity, a health care service plan subject to Section 1367.01 shall not base decisions to deny requests by providers for authorization for mental health services or to deny claim reimbursement for mental health services on either of the following:

(a)Whether admission was voluntary or involuntary.

(b)The method of transportation to the health facility.

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In addition to complying with subdivision (h) of Section 1367.01, in determining whether to approve, modify, or deny requests by providers prior to, retrospectively, or concurrent with the provision of health care services to enrollees, based in whole or in part on medical necessity, a health care service plan subject to Section 1367.01 shall not base decisions to deny requests by providers for authorization for mental health services or to deny claim reimbursement for mental health services on either of the following:
(a)
Whether admission was voluntary or involuntary.
(b)
The method of transportation to the health facility.

California § 1367.015. (1367.015. (Added by Stats. 2008, Ch. 722, Sec. 1.)) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.