Section 97318 - Coordination of Data Submissions(a) If a plan contracts with other entities to administer plan benefits, the plan shall be responsible for the submission of all data for the plan's members. Entities that are contracted to administer plan benefits may include, but are not limited to, pharmacy benefit managers, behavioral health organizations, and, for a health plan, entities with a restricted or limited license under the Knox-Keene Health Service Plan Act of 1975. The plan shall either: (1) Obtain necessary data from the contracted entity and submit the data to the system, or(2) Ensure that the contracted entity submits the data directly to the system. (A) The plan shall identify each contracted entity through the registration process.(B) Each contracted entity shall register pursuant to Article 4 and this entity will be referred to as a delegated submitter.Cal. Code Regs. Tit. 22, § 97318
Note: Authority cited: Section 127673, Health and Safety Code. Reference: Sections 127671.1, 127673 and 127673.1, Health and Safety Code.
Note: Authority cited: Section 127673, Health and Safety Code. Reference: Sections 127671.1, 127673 and 127673.1, Health and Safety Code.
1. New section filed 12-20-2021 as an emergency; operative 12/20/2021 (Register 2021, No. 52). Pursuant to Health and Safety Code section 12763(f), a Certificate of Compliance must be transmitted to OAL by 12-20-2023 or emergency language will be repealed by operation of law on the following day. For prior history of chapter 11, see Register 87, No. 15.
2. Certificate of Compliance as to 12-20-2021 order transmitted to OAL 10-13-2023 and filed 11/17/2023 (Register 2023, No. 46).