Section 51328 - Outpatient Heroin Detoxification Services(a) Routine elective heroin detoxification services are covered, subject to prior authorization, only as an outpatient service. Outpatient services are limited to a maximum period of 21 days. Inpatient hospital services shall be limited to patients with serious medical complications of addiction or to patients with associated medical problems which require inpatient treatment. Hospital admission is subject to the provisions of 51327 (a).(b) A new course of outpatient heroin detoxification treatment shall not be covered until at least 28 days have elapsed since the completion of an immediately preceding course of treatment. New courses of outpatient heroin detoxification treatment by the same provider which are started in the period between the 29th through the 90th days following completion of an immediately preceding course of treatment shall be reimbursed at the rates listed under Section 51533(a) (2) and (3). The daily rate listed under Section 51533(a) (1) shall not be billed by the same provider or separately by a physician employee of that provider until 90 days have elapsed. The patient may be considered a new patient for reimbursement purposes after 90 days following the completion of the immediately preceding course of heroin detoxification.(c) The patient may be considered a new patient for reimbursement purposes by a new provider for heroin detoxification services started in the period between the 29th through the 90th days following completion of an immediately preceding course of heroin detoxification services only if the fact of the preceding course is denied or misrepresented by the patient. Otherwise reimbursement shall be according to Section (b).Cal. Code Regs. Tit. 22, § 51328
1. New section filed 6-23-77; effective thirtieth day thereafter (Register 77, No. 26).
2. Amendment of subsection (a) filed 9-1-82 as an emergency; effective upon filing (Register 82, No. 37). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 12-30-82.
3. Certificate of Compliance transmitted to OAL 12-28-82 and withdrawn 1-27-83 (Register 83, No. 5).
4. Amendment of subsection (a) refiled 1-27-83 as an emergency; effective upon filing (Register 83, No. 5). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 5-27-83.
5. Certificate of Compliance transmitted to OAL 5-26-83 and filed 6-30-83 (Register 83, No. 27).
6. Change without regulatory effect of NOTE (Register 86, No. 49). Note: Authority cited: Sections 10725, 14105 and 14124.5, Welfare and Institutions Code; and Section 57(c), Chapter 328, Statutes of 1982. Reference: Sections 14131, 14132, 14133 and 14133.25, Welfare and Institutions Code.
1. New section filed 6-23-77; effective thirtieth day thereafter (Register 77, No. 26).
2. Amendment of subsection (a) filed 9-1-82 as an emergency; effective upon filing (Register 82, No. 37). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 12-30-82.
3. Certificate of Compliance transmitted to OAL 12-28-82 and withdrawn 1-27-83 (Register 83, No. 5).
4. Amendment of subsection (a) refiled 1-27-83 as an emergency; effective upon filing (Register 83, No. 5). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 5-27-83.
5. Certificate of Compliance transmitted to OAL 5-26-83 and filed 6-30-83 (Register 83, No. 27).
6. Change without regulatory effect of NOTE (Register 86, No. 49).