California Insurance Code

§ 10192.13

INS § 10192.13 Effective Jul 2, 2009Div. 2 · Part 2 · Ch. 1 · Art. 6

Statute text

(a)An issuer shall comply with Section 1882(c)(3) of the federal Social Security Act (as enacted by Section 4081(b)(2)(C) of the federal Omnibus Budget Reconciliation Act of 1987 (OBRA), Public Law 100-203) by doing all of the following and by certifying compliance on the Medicare supplement insurance experience reporting form:

(1)Accepting a notice from a Medicare Administrative Contractor, formerly known as a fiscal intermediary or carrier, on dually assigned claims submitted by participating physicians and suppliers as a claim for benefits in place of any other claim form otherwise required and making a payment determination on the basis of the information contained in that notice.

(2)Notifying the participating physician or supplier and the beneficiary of the payment determination.

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Legislative history

Amended by Stats. 2009, Ch. 10, Sec. 23. Effective July 2, 2009.