28 CA ADC § 1300.77.3


      28 CCR s 1300.77.3

      Cal. Admin. Code tit. 28, s 1300.77.3


      CALIFORNIA CODE OF REGULATIONS
      TITLE 28. MANAGED HEALTH CARE
      DIVISION 1. THE DEPARTMENT OF MANAGED HEALTH CARE
      CHAPTER 2. HEALTH CARE SERVICE PLANS
      ARTICLE 9. FINANCIAL RESPONSIBILITY
      RISK-BEARING ORGANIZATIONS
      This database is current through 06/09/06, Register 2006, No. 23.

      s 1300.77.3. Report on Reimbursements Exceeding Ten Percent.

      (a) Every plan which reimburses providers of health care services or 
      subscribers and enrollees in the manner described in subdivision (a) or 
      (b) of Section 1377 of the Act shall make and maintain as part of its 
      records a computation for each calendar month and calendar quarter of 
      reimbursements made, classified as provided in Section 1377, and showing 
      the percentage of each class of reimbursements made to total expenditures 
      for health care services during such month or quarter.

      (b) When a report is required by subdivision (a) of Section 1377 of the 
      Act, such report shall be filed with the Director no later than 30 
      business days after the close of the calendar quarter.

      (c) When a report is required by subdivision (b) of Section 1377 of the 
      Act, such report shall be filed with the Director no later than 30 
      business days after the close of the calendar month during which actual 
      reimbursements made, or the amount estimated for incurred and unreported 
      claims, exceeds 10 percent of its total expenditures for health care 
      services.


      


      Note: Authority cited: Section 1344, Health and Safety Code. Reference: 
      Section 1377, Health and Safety Code. 


       HISTORY 
         
      1. Editorial correction adding NOTE filed 12-8-82 (Register 82, No. 50).

      2. Change without regulatory effect amending subsections (b) and (c) filed 
      7-
      18-2000 pursuant to section 100, title 1, California Code of Regulations 
      (Register 2000, No. 29).
      28 CA ADC s 1300.77.3

      END OF DOCUMENT

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