Section 1339.7 Of Article 10. Primary Health Service Hospitals From California Health And Safety Code >> Division 2. >> Chapter 2. >> Article 10.
1339.7
. The state department shall administer the program
authorized in this article. In administering the program, the state
department shall do all of the following:
(a) Verify hospital eligibility, pursuant to Section 1339.9, and
designate those hospitals as primary health service hospitals.
(b) Establish criteria for the health service plans pursuant to
Section 1339.15.
(c) Review a general acute care hospital's health service plan
based upon recommendations of the local health systems agency, input
from local public meetings, recommendations of the medical advisory
panel, as appropriate, and the adequacy of the plan in meeting the
criteria established pursuant to this section. The state department
shall approve, deny, or defer the plan in whole or in part and shall
notify the hospital of its findings, in writing, within 120 days
after receipt of the plan. The plan shall be deemed approved if the
hospital has not received notification from the state department
within the 120-day period.
(d) Negotiate and grant exceptions to the licensure requirements
for general acute care hospitals that are necessary to serve the
purposes of this article when the granting of such exceptions do not
jeopardize the health and welfare of the patients. Exceptions that
are granted shall be consistent with the primary health service
hospital's plan and any amendments thereto.
(e) Convene an advisory panel to review the medical-surgical and
obstetrical services proposed as part of the primary hospital service
plan and make recommendations to the state department on the medical
appropriateness of those services according to the primary health
service hospital's proposed plan. The panel shall include, but not be
limited to, a rural hospital administrator, a rural family practice
physician and surgeon, a rural hospital nurse administrator, an
internist, a primary care mid-level practitioner, and a physician and
surgeon from a hospital which serves as a referral center for rural
hospitals.
(f) Issue evidence of primary health service hospital designation
and evidence of the number of acute care beds approved as swing beds
pursuant to paragraph (4) of subdivision (b) of Section 1339.15.
(g) Monitor the performance of the primary health service hospital
to assure compliance with such hospital's plan and licensure
requirements from which such hospitals are not exempt.
(h) Immediately upon the denial of a primary health service
hospital's health service plan, or a portion thereof, notify the
hospital in writing. Within 20 days after the state department mails
the notice, the hospital may present a written petition for a hearing
to the state department. Upon receipt by the state department of the
petition in proper form, the petition shall be set for hearing. The
proceedings shall be conducted in accordance with Chapter 5
(commencing with Section 11500) of Part 1 of Division 3 of Title 2 of
the Government Code, and the state department has all the powers
granted therein.
(i) Compile and make available to health systems agencies and
primary health service hospitals, information regarding state and
federal funding programs for which the primary health service
hospital may be eligible, the procedures necessary to apply for
funding, and a description of how such requests may be incorporated
into a primary health service hospital's plan and opportunities for
diversification of services, the requirements and feasibility, and
the procedures for development of such services.
(j) On behalf of primary health service hospitals, seek
appropriate federal waivers consistent with the intent of this act.
(k) Contract with one or more health systems agencies to perform
the functions specified in subdivision (c) of Section 1339.11.
(l) Develop or assist hospitals submitting a primary health
service plan pursuant to Section 1339.15 to develop the following:
(1) Alternative methods of filing claims which reduce
administrative costs.
(2) Alternative methods of Medi-Cal payment to hospitals.
(3) Other methods of filing claims which reduce administrative
costs.
(4) Simplified and abbreviated procedures required by the
department of Medi-Cal costs reports.
(5) An abbreviated medical and social review process and other
control processes.
(m) Provide technical assistance to primary health service
hospitals in development of their health service plan.