Section 50781.5 - Potential Overpayments - Unreported Other Health Coverage(a) A potential overpayment occurs when a beneficiary, or the person acting on the beneficiary's behalf, has knowingly failed to report other health coverage under either of the following circumstances: (1) The other health coverage is of a type designated by the Department as not subject to post-service reimbursement, and the beneficiary who fails to utilize such other health coverage without good cause; or(2) The beneficiary has received services for which Medi-Cal paid, and the beneficiary also claimed and received payment through private health care coverage.Cal. Code Regs. Tit. 22, § 50781.5
1. New section filed 4-13-93; operative 5-13-93 (Register 93, No. 16). Note: Authority cited: Sections 10725 and 14124.5, Welfare and Institutions Code. Reference: Sections 14009, 14016.4 and 14024, Welfare and Institutions Code.
1. New section filed 4-13-93; operative 5-13-93 (Register 93, No. 16).