Cal. Code Regs. tit. 17 § 6540

Current through Register 2025 Notice Reg. No. 2, January 10, 2025

Section 6540 - Program Participation Fees

(a) The all-inclusive program participation fee for prenatal screening for neural tube defects, shall be $85.00. The fee shall be paid to the Department by the individual being tested or by any third party which is legally responsible for the individual's care, including any health care service plan, managed health care plan, managed care plan, prepaid health plan or prepaid group practice health care service plan as defined in or licensed in accordance with Health and Safety Code Section 1340, et seq. Uncollected fees shall be collected through the California Franchise Tax Board.

(b) The all-inclusive program participation fee for prenatal screening for fetal autosomal trisomies shall be $344.00. The fee shall be paid to the Department by the individual being tested or by any third party which is legally responsible for their care, including any health care service plan, managed health care plan, managed care plan, prepaid health plan or prepaid group practice health care service plan as defined or licensed in accordance with Health and Safety Code Section 1340, et seq. Uncollected fees shall be collected through the California Franchise Tax Board.

(c) Any third party responsible for the prenatal healthcare of any individual that opts to participate in the California Prenatal Screening Program, including any health care service plan, managed health care plan, managed care plan, prepaid health plan or prepaid group practice health care service plan as defined or licensed in accordance with Health and Safety Code section 1340, et seq., shall not:

(1) Require prior authorization for California Prenatal Screening Program cfDNA or MSAFP screening test fees before covering the cost for services; or

(2) Delay or defer payment of services pending the receipt of medical records or report.

Cal. Code Regs. Tit. 17, § 6540

Note: Authority cited: Sections 124977, 124996, 125000, 125055, 125070 and 131200, Health and Safety Code. Reference: Sections 124996, 125000(b), 125000(f), 125001, 125050, 125060, 125065 and 131052, Health and Safety Code.

1. Change without regulatory effect adopting article 4 (sections 6540-6540.1) and section filed 10-12-2006 pursuant to section 100, title 1, California Code of Regulations (Register 2006, No. 41).
2. Change without regulatory effect amending section and Note filed 2-16-2007 pursuant to section 100, title 1, California Code of Regulations (Register 2007, No. 7).
3. Amendment of section and Note filed 9-23-2011 as an emergency; operative 9-23-2011 (Register 2011, No. 38). Pursuant to Health and Safety Code section 124977(d)(1), this regulation was submitted to OAL as a file and print only and was not subject to OAL review. Health and Safety Code section 124977(d)(2) provides this emergency amendment shall not be repealed by OAL and shall remain in effect until revised or repealed by the Department.
4. Statement of Compliance pursuant to Health and Safety Code section 124977(d)(1) as to 9-23-2011 order filed 1-26-2012. Exempt from OAL review pursuant to Health and Safety Code section 124977(d)(2). Submitted to OAL for filing pursuant to Government Code section 11343.8 (Register 2012, No. 4).
5. Amendment of section and Note filed 6-27-2014 as an emergency; operative 6/27/2014 (Register 2014, No. 26). Pursuant to Health and Safety Code section 124977(d)(1), this regulation was submitted to OAL as a file and print only and was not subject to OAL review. Health and Safety Code section 124977(d)(2)provides this emergency amendment shall not be repealed by OAL and shall remain in effect until revised or repealed by the Department.
6. Statement of Compliance pursuant to Health and Safety Code section 124977(d)(1) as to 6-27-2014 order filed 2/5/2015. Exempt from OAL review pursuant to Health and Safety Code section 124977(d)(2). Submitted to OAL for filing pursuant to Government Code section 11343.8 (Register 2015, No. 8).
7. Amendment filed 7-1-2016 as a deemed emergency file and print action, exempt from OAL review pursuant to Health and Safety Code section 124977(d)(1); operative 7/1/2016 (Register 2016, No. 27). The amendments shall remain in effect until revised or repealed by the Department of Public Health pursuant to Health and Safety Code section 124977(d)(2).
8. Statement of Compliance pursuant to Health and Safety Code section 124977(d)(1) as to 7-1-2016 order filed 9-6-2017. Exempt from OAL review pursuant to Health and Safety Code section 124977(d)(2). Submitted to OAL for filing pursuant to Government Code section 11343.8 (Register 2017, No. 36).
9. Amendment of article 4 heading filed 12-20-2019 as an emergency; operative 12/20/2019 pursuant to Health and Safety Code section 124977(d). Submitted to OAL for filing and printing only pursuant to Health and Safety Code section 124977(d) (Register 2019, No. 51). Pursuant to Health and Safety Code section 124977(d)(2), these regulations shall remain in effect until revised or repealed by the department.
10. Statement of Compliance pursuant to Health and Safety Code section 124977(d)(1) as to 12-20-2019 order filed 12-11-2020. Exempt from OAL review pursuant to Health and Safety Code section 124977(d)(2). Submitted to OAL for filing and printing only pursuant to Government Code section 11343.8 (Register 2020, No. 50).
11. Amendment of section heading and section filed 7-18-2022 as an emergency; operative 7/18/2022 pursuant to Health and Safety Code section 124977(d). Submitted to OAL for filing and printing only pursuant to Health and Safety Code section 124977(d) (Register 2022, No. 29). Pursuant to Health and Safety Code section 124977(d)(2), these regulations shall remain in effect until revised or repealed by the department.
12. Refiling of 7-18-2022 emergency amendments, including further amendment of subsection (b), on 9-9-2022 as an emergency; operative 9/9/2022 pursuant to Health and Safety Code section 124977(d) (Register 2022, No. 36). Pursuant to Health and Safety Code section 124977(d)(2), these regulations shall remain in effect until revised or repealed by the department.
13. Amendment of subsection (b), repealer of subsection (c) and new subsections (c)-(c)(2) filed 4-3-2024 as an emergency; operative 4/3/2024 pursuant to Health and Safety Code section 124977(d). Submitted to OAL for filing and printing only pursuant to Health and Safety Code section 124977 (Register 2024, No. 14). Pursuant to Health and Safety Code section 124977(d)(2), these regulations shall remain in effect until revised or repealed by the department.