California Welfare and Institutions Code ARTICLE 3 - Administration

• Section 14300.
  The department shall publish a notice of intent to contract at least 60 days prior to the effective date of any initial or renewed contract....
• Section 14301.
  (a) The department shall determine, by actuarial methods, prospective per capita rates of payment for services provided under this chapter for Medi-Cal beneficiaries enrolled in a...
• Section 14301.1.
  (a) For rates established on or after August 1, 2007, the department shall pay capitation rates to health plans participating in the Medi-Cal managed care program...
• Section 14301.2.
  (a) The director may defer fee-for-service payments or payments to Medi-Cal managed care health plans contracting with the department pursuant to Article 2.7 (commencing with Section...
• Section 14301.4.
  (a) It is the intent of the Legislature, to the extent federal financial participation is not jeopardized and consistent with federal law, that the intergovernmental transfers...
• Section 14301.5.
  (a) (1) To the extent federal financial participation is not jeopardized and consistent with federal law, and subject to the conditions set forth in subdivision (b), the...
• Section 14302.
  Except as provided in Section 14490, the duration of initial contracts entered into pursuant to this chapter shall be for a maximum of one year...
• Section 14302.1.
  Once it is determined that a contract shall be renewed pursuant to the provisions of this chapter with a prepaid health plan, by the state...
• Section 14303.
  No contract between the department and the prepaid health plan shall be amended without the public notice and if necessary the holding of a public...
• Section 14303.1.
  The department shall have authority to amend a prepaid health plan contract in accordance with the terms of a merger of a prepaid health plan...
• Section 14303.2.
  The department shall have authority to amend a prepaid health plan contract in accordance with the terms of the reorganization of a prepaid health plan...
• Section 14303.3.
  The department shall renew a contract unless good cause is shown for nonrenewal.(Added by Stats. 1980, Ch. 1073, Sec. 6.)
• Section 14304.
  (a) The director shall terminate a contract with a prepaid health plan or a Medi-Cal managed health care plan if he or she finds that the...
• Section 14304.5.
  Each prepaid health plan shall provide directly or through subcontractors, not less than the basic scope of health care benefits as defined in Section 14256....
• Section 14305.
  The department may limit the scope of health care benefits provided by a prepaid health plan under this chapter to exclude the care of illness...
• Section 14308.
  (a) Each prepaid health plan shall furnish to the director such information and reports as required by Title XIX of the federal Social Security Act.(b) The director...
• Section 14309.
  The department shall provide for a continuing study of the quality of care and services resulting from the operation of this chapter and for surveys...
• Section 14311.
  Prepaid health plans, the services they provide, and the persons receiving these services shall not be subject to the limitations on services set forth in...
• Section 14312.
  The director shall adopt all necessary rules and regulations to carry out the provisions of this chapter. In adopting such rules and regulations, the director...
• Section 14314.
  The director may recover a due and payable overpayment made to a prepaid health plan by means of a repayment agreement executed between such prepaid...
• Section 14315.
  When it has been determined that a prepaid health plan has received an overpayment which is due and payable, the director may recover such overpayment...
• Section 14316.
  Notwithstanding any other provisions of law, contracts with plans which are entered into, renewed, or amended pursuant to this article may include one or more...

Last modified: October 22, 2018