Cal. Welf. and Inst. Code § 14133.14
Current through the 2023 Legislative Session.
The criteria that the department shall use to identify providers to be placed on prior authorization for noninvasive testing procedures shall include, but not be limited to, Medi-Cal trend analysis, provider profiling data, provider and beneficiary history data, or appropriateness of the services as related to diagnosis, volume of services, utilization patterns, and specialty of provider. The existing prior authorization appeals process shall be available to these providers for denial of services.
Ca. Welf. and Inst. Code § 14133.14