Cal. Code Regs. Tit. 22, § 53862 - Reporting
Each plan in a designated region shall submit to the department:
(a) Annual reports which
shall include:
(1) The financial audit
required by section
53340. In addition to the annual
audited financial statements, the plan shall include the annual report required
under section
1300.84.06, Title 10. The plan's
annual report shall have a supplemental income statement, prepared in a format
consistent with the annual report, reflecting the plan's various Medi-Cal
contracts each as a separate line of business by designated region which come
included.
(2) An update of the
provider listing required in section
53242(b).
(b) Quarterly reports which shall include:
(1) Each plan shall submit to the department,
within 45 days after the close of each fiscal quarter, a quarterly financial
report in the format prescribed by Title 10, section
1300.84.2. The required financial
reports shall have a supplemental income statement, reflecting the plan's
various Medi-Cal contracts as separate business operations of the plan by
designated region, which combines and correlates to the submitted income
statement for the plan.
(c) Other reports which shall be submitted to
the department shall include the following:
(1) Utilization and statistical data,
including detailed encounter level data, in compliance with the requirements of
the contract between the plan and the department.
(2) Pediatric preventive services provided in
accordance with the Child Health and Disability Prevention Program reports
disclosing services rendered in accordance with Health and Safety Code section
320,
et seq., and Title 17, CCR, sections
6840 through
6850 as required by the contract
between the plan and the department.
(3) Information requested by the department
to conduct medical reviews or contract monitoring in accordance with section
14457,
Welfare and Institutions Code.
(4)
Financial reports relevant to affiliates as specified in section
53330. These reports will include
at a minimum financial statements of affiliates and, if publicly traded, copies
of the quarterly Form 10-Q and annual Form 10-K as required by the Securities
and Exchange Commission.
(5) Copies
of any financial reports submitted to other public or private organizations as
specified in section
53324(d).
(6) Upon request, monthly financial
statements.
(7) Notification of
possible third-party tort liability or estate recovery situations. This
information shall be submitted within ten days of discovery.
(8) Reports specified in the contract between
the plan and the department.
(9) On
a monthly basis, an updated listing of the plan's provider network, by
specialty.
(d) Each plan
shall submit to public health authorities reports required by state
law.
Notes
2. Repealer of section and NOTE and new section and NOTE filed 3-4-97; operative 3-4-97. Submitted to OAL for printing only pursuant to Section 147, SB 485 (Ch. 722/92) (Register 97, No. 10).
Note: Authority cited: Sections 10725, 14105, 14124.5 and 14312, Welfare and Institutions Code. Reference: Sections 14087.3, 14087.4 and 14308, Welfare and Institutions Code.
2. Repealer of section and Note and new section and Note filed 3-4-97; operative 3-4-97. Submitted to OAL for printing only pursuant to Section 147, SB 485 (Ch. 722/92) (Register 97, No. 10).
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.