California Health and Safety Code

§ 1371.36

HSC § 1371.36 Effective Jan 1, 2001Div. 2 · Ch. 2.2 · Art. 5

Statute text

(a)A health care service plan shall not deny payment of a claim on the basis that the plan, medical group, independent practice association, or other contracting entity did not provide authorization for health care services that were provided in a licensed acute care hospital and that were related to services that were previously authorized, if all of the following conditions are met:

(1)It was medically necessary to provide the services at the time.

(2)The services were provided after the plan’s normal business hours.

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Legislative history

Added by Stats. 2000, Ch. 827, Sec. 5. Effective January 1, 2001.