California Welfare and Institutions Code

§ 14133.9

WIC § 14133.9 Effective Jan 1, 2013Div. 9 · Part 3 · Ch. 7 · Art. 4

Statute text

The implementation of prior authorization permitted by subdivision (a) of Section 14133 shall be subject to all of the following provisions:

(a)The department shall secure a toll free phone number for the use of providers of Medi-Cal services listed in Section 14132. For providers, the department shall provide access to an individual knowledgeable in the program to provide Medi-Cal providers with information regarding available services. Access shall include a toll-free phone number that provides reasonable access to that person. The number shall be operated 24 hours a day, seven days a week.

(b)For major categories of treatment subject to prior authorization, the department shall publicize and continue to develop its list of objective medical criteria that indicate when authorization should be granted. Any request meeting these criteria, as determined by the department, shall be approved, or deferred as authorized in subdivision (e) by specific medical information.

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Legislative history

Amended by Stats. 2012, Ch. 728, Sec. 206. (SB 71) Effective January 1, 2013.