28 CA ADC § 1300.67.3


      28 CCR s 1300.67.3

      Cal. Admin. Code tit. 28, s 1300.67.3


      CALIFORNIA CODE OF REGULATIONS
      TITLE 28. MANAGED HEALTH CARE
      DIVISION 1. THE DEPARTMENT OF MANAGED HEALTH CARE
      CHAPTER 2. HEALTH CARE SERVICE PLANS
      ARTICLE 7. STANDARDS
      This database is current through 06/09/06, Register 2006, No. 23.

      s 1300.67.3. Standards for Plan Organization.

      (a) The organization of each plan shall provide the capability to furnish 
      in a reasonable and efficient manner the health care services for which 
      subscribers and enrollees have contracted. Such organization shall 
include:

      (1) separation of medical services from fiscal and administrative 
      management sufficient to assure the Director that medical decisions will 
      not be unduly influenced by fiscal and administrative management,

      (2) staffing in medical and other health services, and in fiscal and 
      administrative services sufficient to result in the effective conduct of 
      the plan's business, and

      (3) written procedures for the conduct of the business of the plan, 
      including the provision of health care services, so as to provide 
      effective controls.


      


      Note: Authority cited: Section 1344, Health and Safety Code. Reference: 
      Section 1367, Health and Safety Code. 


       HISTORY 
         
      1. Amendment filed 1-12-83; effective thirtieth day thereafter (Register 
      83, 
      No. 3).

      2. Change without regulatory effect amending subsection (a)(1) filed 
      7-18-2000
      pursuant to section 100, title 1, California Code of Regulations (Register
      2000, No. 29).
      28 CA ADC s 1300.67.3

      END OF DOCUMENT

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