California Health and Safety Code

§ 1371.39

HSC § 1371.39 Effective Jan 1, 2019Div. 2 · Ch. 2.2 · Art. 5

Statute text

(a)Providers may report to the department through the toll-free provider line, email address, or another method designated by the department, instances in which the provider believes a plan is engaging in an unfair payment pattern.

(b)Plans may report to the department through the toll-free provider line, email address, or another method designated by the department, instances in which the plan believes a provider is engaging in an unfair billing pattern.

(c)“Unfair billing pattern” means engaging in a demonstrable and unjust pattern of unbundling of claims, upcoding of claims, or other demonstrable and unjustified billing patterns, as defined by the department.

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Legislative history

Amended by Stats. 2018, Ch. 303, Sec. 1. (AB 2674) Effective January 1, 2019.