California Health and Safety Code ARTICLE 6 - Operation and Renewal Requirements and Procedures

• Section 1375.1.
  (a) Every plan shall have and shall demonstrate to the director that it has all of the following:(1) A fiscally sound operation and adequate provision against the...
• Section 1375.2.
  On and after October 1, 1977, every plan operating under a transitional license shall have a fiscally sound operation.(Added by Stats. 1977, Ch. 818.)
• Section 1375.3.
  (a)  A health care service plan shall meet and confer with the director and his or her designated representatives at least 10 business days prior...
• Section 1375.4.
  (a) Every contract between a health care service plan and a risk-bearing organization that is issued, amended, renewed, or delivered in this state on or after...
• Section 1375.5.
  No contract between a risk-bearing organization and a health care service plan that is issued, amended, delivered, or renewed in this state on or after...
• Section 1375.6.
  No contract between a risk-bearing organization and a health care service plan that is issued, amended, delivered, or renewed in this state on or after...
• Section 1375.7.
  (a) This section shall be known and may be cited as the Health Care Providers’ Bill of Rights.(b) No contract issued, amended, or renewed on or after...
• Section 1375.8.
  (a)  The Legislature finds the following: (1)  Because of the nature and cost of certain medical items, the financial risk of these items is better...
• Section 1375.9.
  (a) A health care service plan shall ensure that there is at least one full-time equivalent primary care physician for every 2,000 enrollees of the plan....
• Section 1376.
  (a) No plan shall conduct any activity regulated by this chapter in contravention of such rules and regulations as the director may prescribe as necessary or...
• Section 1376.1.
  The deposit requirements of Section 1300.76.1 of Title 28 of the California Code of Regulations shall not apply to any plan operated by a county,...
• Section 1377.
  (a) Every plan which reimburses providers of health care services that do not contract in writing with the plan to provide health care services, or which...
• Section 1378.
  No plan shall expend for administrative costs in any fiscal year an excessive amount of the aggregate dues, fees and other periodic payments received by...
• Section 1379.
  (a)  Every contract between a plan and a provider of health care services shall be in writing, and shall set forth that in the event...
• Section 1379.5.
  (a) On and after July 1, 2008, every contract between a plan and a health care provider who provides health care services in Mexico to an...
• Section 1380.
  (a)  The department shall conduct periodically an onsite medical survey of the health delivery system of each plan. The survey shall include a review of...
• Section 1380.1.
  (a)  The Legislature finds and declares as follows: (1)  Multiple medical quality audits of health care providers, as many as 25 for some physician offices,...
• Section 1380.3.
  The department shall coordinate the surveys conducted pursuant to Section 1380 with the State Department of Health Care Services, to the extent possible, in order...
• Section 1381.
  (a) All records, books, and papers of a plan, management company, solicitor, solicitor firm, and any provider or subcontractor providing health care or other services to...
• Section 1382.
  (a) The director shall conduct an examination of the fiscal and administrative affairs of any health care service plan, and each person with whom the plan...
• Section 1383.
  Every plan that is a health maintenance organization qualified under Section 1310(d) of Title XIII of the federal Public Health Service Act, shall provide the...
• Section 1383.1.
  (a)  On or before July 1, 1997, every health care service plan shall file with the department a written policy, which is not subject to...
• Section 1383.15.
  (a)  When requested by an enrollee or participating health professional who is treating an enrollee, a health care service plan shall provide or authorize a...
• Section 1384.
  (a) Within 90 days after receipt of a request from the director, a plan or other person subject to this chapter shall submit to the director...
• Section 1385.
  Each plan, solicitor firm, and solicitor shall keep and maintain current such books of account and other records as the director may by rule require...

Last modified: October 22, 2018