Cal. Code Regs. tit. 9 § 1810.360

Current through Register 2024 Notice Reg. No. 23, June 7, 2024

Section 1810.360 - Notification of Beneficiaries

(a) The MHP shall develop, implement and maintain written policies that address the beneficiary's rights in accordance with title 42 CFR section 438.100 and shall communicate these policies to its beneficiaries and providers.

(b) Prior to the date the MHP begins operation, the Department shall mail a notice to all beneficiaries in a county containing the following information:

(1) The date the MHP will begin operation.

(2) The name and statewide, toll-free telephone number of the MHP.

(3) The availability of a booklet and provider list that contain the information required by Title 42, Code of Federal Regulations, Section 438.10(f)(6) and (g).

(4) The availability of problem resolution processes, including fair hearings.

(c) The Department shall provide beneficiaries who become eligible for Medi-Cal after the notice described in Subsection (a) is mailed with a notice containing the information listed in Subsections (a)(2)-(4) either through the mail or through the Medi-Cal eligibility determination process.

(d) The Department shall provide an annual written notice to all Medi-Cal beneficiaries informing them of their right to request and obtain a booklet and provider list from the MHP that contain the information required by Title 42, Code of Federal Regulations, Section 438.10(f)(6) and (g).

(e) The MHP of the beneficiary shall provide its beneficiaries with a booklet and provider list upon request and when a beneficiary first receives a specialty mental health service from the MHP or its contract providers. This responsibility applies to the beneficiary's receipt of any specialty mental health service, including but not limited to an assessment to determine whether medical necessity criteria pursuant to Section 1830.205 are met.

(f) The booklet and provider list shall be updated as required by the contract between the Department and the MHP. Pursuant to Title 42, Code of Federal Regulations, Section 438.10(f)(4), when there is a change in the scope of specialty mental health services covered by the MHP, an update in the form of a booklet insert shall be provided to beneficiaries at least 30 days prior to the change.

(g) The booklet shall be updated to reflect changes in State laws governing advance directives as soon as possible, but no later than 90 days after the effective date of the change. The MHP shall maintain written policies and procedures respecting advance directives in compliance with the requirements of title 42 CFR sections 422.128 and 438.6(i)(1), (3) and (4).

(h) The MHP shall provide written notice to beneficiaries in regards to the termination of a provider's contract as required by title 42 CFR section 438.10(f)(5).

Cal. Code Regs. Tit. 9, § 1810.360

1. New section filed 10-31-97 as an emergency; operative 11-1-97 (Register 97, No. 44). A Certificate of Compliance must be transmitted to OAL by 3-2-98 or emergency language will be repealed by operation of law on the following day.
2. New section refiled 3-2-98 as an emergency; operative 3-2-98 (Register 98, No. 10). A Certificate of Compliance must be transmitted to OAL by 6-30-98 or emergency language will be repealed by operation of law on the following day.
3. New section refiled 6-17-98 as an emergency; operative 6-30-98 (Register 98, No. 25). Pursuant to Chapter 324 (Statutes of 1998) Item 4440-103-0001(4), a Certificate of Compliance must be transmitted to OAL by 7-1-99 or emergency language will be repealed by operation of law on the following day.
4. Editorial correction of HISTORY 3 (Register 98, No. 39).
5. Editorial correction extending Certificate of Compliance date to 7-1-2001 pursuant to Chapter 50 (Statutes of 1999) Item 4440-103-0001(4) (Register 99, No. 33). Notwithstanding any other provision of law, emergency regulations adopted pursuant to Welfare and Institutions Code section 14680 to implement the second phase of mental health managed care as provided in this part shall remain in effect until permanent regulations are adopted, or June 30, 2006, whichever occurs first.
6. Editorial correction of HISTORY 5 (Register 2000, No. 42).
7. Editorial correction of HISTORY 5 and repealer and new section filed 5-19-2006; operative 6-18-2006 (Register 2006, No. 20).
8. New subsections (a), (g) and (h), subsection relettering and amendment of NOTE filed 10-18-2010; operative 11-17-2010 (Register 2010, No. 43).

Note: Authority cited: Section 14680, Welfare and Institutions Code. Reference: Section 14683, Welfare and Institutions Code; and Title 42, Code of Federal Regulations, Sections 422.128, 438.10 and 438.6(i)(1), (3) and (4).

1. New section filed 10-31-97 as an emergency; operative 11-1-97 (Register 97, No. 44). A Certificate of Compliance must be transmitted to OAL by 3-2-98 or emergency language will be repealed by operation of law on the following day.
2. New section refiled 3-2-98 as an emergency; operative 3-2-98 (Register 98, No. 10). A Certificate of Compliance must be transmitted to OAL by 6-30-98 or emergency language will be repealed by operation of law on the following day.
3. New section refiled 6-17-98 as an emergency; operative 6-30-98 (Register 98, No. 25). Pursuant to Chapter 324 (Statutes of 1998) Item 4440-103-0001(4), a Certificate of Compliance must be transmitted to OAL by 7-1-99 or emergency language will be repealed by operation of law on the following day.
4. Editorial correction of History 3 (Register 98, No. 39).
5. Editorial correction extending Certificate of Compliance date to 7-1-2001 pursuant to Chapter 50 (Statutes of 1999) Item 4440-103-0001(4) (Register 99, No. 33). Notwithstanding any other provision of law, emergency regulations adopted pursuant to Welfare and Institutions Code section 14680 to implement the second phase of mental health managed care as provided in this part shall remain in effect until permanent regulations are adopted, or June 30, 2006, whichever occurs first.
6. Editorial correction of History 5 (Register 2000, No. 42).
7. Editorial correction of History 5 and repealer and new section filed 5-19-2006; operative 6-18-2006 (Register 2006, No. 20).
8. New subsections (a), (g) and (h), subsection relettering and amendment of Note filed 10-18-2010; operative 11-17-2010 (Register 2010, No. 43).