28 CA ADC § 1300.43.12


      28 CCR s 1300.43.12

      Cal. Admin. Code tit. 28, s 1300.43.12


      CALIFORNIA CODE OF REGULATIONS
      TITLE 28. MANAGED HEALTH CARE
      DIVISION 1. THE DEPARTMENT OF MANAGED HEALTH CARE
      CHAPTER 2. HEALTH CARE SERVICE PLANS
      ARTICLE 1. EXEMPTIONS
      This database is current through 06/09/06, Register 2006, No. 23.

      s 1300.43.12. Medi-Cal Dental Contract.

      The contract of the Department of Health Services which is entered as the 
      result of successful bidding in response to said Department's request for 
      proposal and which requires the contractor to provide only dental benefits 
      for the state's Medi-Cal beneficiaries pursuant to Section 14104.3 of the 
      Welfare and Institutions Code and incorporates the terms and provisions 
      set forth in the request for proposal, is exempt from the provisions of 
      the Act, if the successful bidder ( "entity") is not already licensed 
      under the Act, for the period indicated below, subject to each of the 
      following:

      (a) The entity engages in no activities as a plan other than those 
      pursuant to the Medi-Cal dental contract described above or pursuant to a 
      separate exemption in the Act or these rules.

      (b) The entity properly files an application for licensure under the Act, 
      as required by Sections 1351 and 1356 of the Act, prior to executing the 
      contract referred to above, except that the information contained in the 
      application submitted at the time of filing need not include information 
      not required to be provided to the Department of Health Services pursuant 
      to its request for proposal, so long as the additional information 
      required by Section 1351 of the Act or by the application form provided by 
      the Director is filed as an amendment to the license application within 
      six weeks of the date of execution of the contract referred to above, or 
      any longer period as the Director by order may allow under the Director's 
      waiver authority set forth in Section 1344(a) of the Act.

      (c) The entity reasonably pursues the completion of its application and 
      compliance with the provisions of the Act and applicable rules thereunder.

      (d) The entity, for the duration of the exemption provided by this 
      section, shall be subject to the provisions of Sections 1351.1, 1381, 
      1384, and 1385 of the Act, and may be examined by the Director in the 
      manner and subject to the arrangements provided in Section 1382 of the 
Act.

      (e) The exemption provided by this section shall be effective only until 
      the earlier of

      (1) final action by the Director on the application, or

      (2) the expiration of nine months after execution of the contract referred 
      to above, except that said nine month period may be waived by order of the 
      Director for any additional one month periods under the Director's waiver 
      authority set forth in Section 1344(a) of the Act.

      (f) For the purposes of this section, the term "order" means a written 
      waiver applicable to a specific case issued by the Director pursuant to 
      Section 1344(a) of the Act.


      


      Note: Authority cited: Sections 1343 and 1344, Health and Safety Code. 
      Reference: Sections 1343, 1344, 1351, 1351.1, 1353, 1356, 1381, 1382, 1384 
      and 1385, Health and Safety Code. 


       HISTORY 
         
      1. New section filed 3-9-84; effective thirtieth day thereafter (Register 
      84, 
      No. 10).

      2. Change without regulatory effect amending subsections (b) and (d)-(f) 
      filed
      7-18-2000 pursuant to section 100, title 1, California Code of Regulations 

      (Register 2000, No. 29).
      28 CA ADC s 1300.43.12

      END OF DOCUMENT

      (C) Copyright 2006, Result Oriented Marketing, Inc.
      For Further Assistance Visit : www.mcmillanlaw.us and www.fearnotlaw.com