Section 1368.03 Of Article 5. Standards From California Health And Safety Code >> Division 2. >> Chapter 2.2. >> Article 5.
1368.03
. (a) The department may require enrollees and subscribers
to participate in a plan's grievance process for up to 30 days before
pursuing a grievance through the department or the independent
medical review system. However, the department may not impose this
waiting period for expedited review cases covered by subdivision (b)
of Section 1368.01 or in any other case where the department
determines that an earlier review is warranted.
(b) Notwithstanding subdivision (a), the department may refer any
grievance issue that does not pertain to compliance with this chapter
to the State Department of Health Services, the California
Department of Aging, the federal Health Care Financing
Administration, or any other appropriate governmental entity for
investigation and resolution.
(c) This section shall become operative on January 1, 2001, and
then only if Assembly Bill 55 of the 1999-2000 Regular Session is
enacted.