Section 1373.21 Of Article 5. Standards From California Health And Safety Code >> Division 2. >> Chapter 2.2. >> Article 5.
1373.21
. (a) If a health care service plan uses arbitration to
settle disputes with enrollees or subscribers, it shall require that
an arbitration award be accompanied by a written decision to the
parties that indicates the prevailing party, the amount of any award
and other relevant terms of the award, and the reasons for the award
rendered.
(b) A copy of any modified written decision, including the amount
of the award and other relevant terms of the award, the reasons for
the award rendered, the name of the arbitrator or arbitrators, but
excluding the names of the enrollee, the plan, witnesses, attorneys,
providers, health plan employees, and health facilities, shall be
provided to the department on a quarterly basis. The department shall
make these modified decisions available to the public upon request.
(c) Subdivision (b) shall not preclude the department from
requesting and securing from any plan copies of complete arbitration
decisions issued pursuant to subdivision (a) for the purposes of
administering this chapter.
(d) If the department receives a request for information about an
arbitration decision obtained by the department pursuant to
subdivision (b) or (c), the department shall not release information
identifying a person or entity whose name has been or should have
been removed from the arbitration decision pursuant to subdivision
(b).
(e) Nothing in this section shall be construed to preclude the
department, or any plan or person, from disclosing information
contained in an arbitration decision if the disclosure is otherwise
permitted by law.