28 CA ADC § 1300.82.1


      28 CCR s 1300.82.1

      Cal. Admin. Code tit. 28, s 1300.82.1


      CALIFORNIA CODE OF REGULATIONS
      TITLE 28. MANAGED HEALTH CARE
      DIVISION 1. THE DEPARTMENT OF MANAGED HEALTH CARE
      CHAPTER 2. HEALTH CARE SERVICE PLANS
      ARTICLE 11. EXAMINATIONS
      This database is current through 06/09/06, Register 2006, No. 23.

      s 1300.82.1. Additional or Nonroutine Examinations and Surveys.

      (a) An examination or survey is additional or nonroutine for good cause 
      for the purposes of Section 1382(b) when the reason for such examination 
      or survey is any of the following:

      (1) The plan's noncompliance with written instructions from the 
Department;

      (2) The plan has violated, or the Director has reason to believe that the 
      plan has violated, any of the provisions of Sections 1352, 1370, 1375.1, 
      1376, 1384 and 1385 of the Act and Sections 1300.76, 1300.80.10, 1300.81, 
      1300.82(a), 1300.84.2 and 1300.84.3 of these regulations.

      (3) The plan has committed, or the Director has reason to believe that the 
      plan has committed, any of the acts or omissions enumerated in Section 
      1386 of the Act.

      (4) The Director deems such additional or nonroutine examination or survey 
      necessary to verify representations made to this Department by a plan in 
      response to a deficiency letter.

      (b) Each situation giving rise to an additional or nonroutine examination 
      or survey shall be evaluated on a case-by-case basis as to the seriousness 
      of the violation, or lack of timely or adequate response by the plan to 
      the Department's request to correct the violation. The plan shall be 
      notified in writing of the provisions of the Act or regulations which have 
      been, or may have been, violated and which therefore caused such 
      additional or nonroutine examination or survey to be performed. The 
      expense of such examinations and surveys shall be charged to the plan 
      being examined or surveyed in accordance with Section 1382(b).


      


      Note: Authority cited: Section 1344, Health and Safety Code. Reference: 
      Sections 1352, 1370, 1375.1, 1376, 1380, 1382, 1384, 1385 and 1386, Health 
      and Safety Code. 


       HISTORY 
         
      1. New section filed 3-3-83; effective thirtieth day thereafter (Register 
      83, 
      No. 10).

      2. Change without regulatory effect amending subsections (a)(2)-(4) filed 
      7-18-
      2000 pursuant to section 100, title 1, California Code of Regulations 
      (Register 2000, No. 29).
      28 CA ADC s 1300.82.1

      END OF DOCUMENT

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