Cal. Code Regs. Tit. 22, § 53893 - Medi-Cal Managed Care Ombudsman

(a) The department may designate a Medi-Cal Managed Care Ombudsman. The Ombudsman shall provide Medi-Cal beneficiaries access to a service which investigates and resolves complaints about managed care plans by, or on behalf of, Medi-Cal beneficiaries.

(b) The duties of the Ombudsman shall include, but not be limited to the following:

(1) Encouraging beneficiaries to avail themselves of the opportunity to obtain health care through Medi-Cal managed care plans.

(2) Assisting beneficiaries by removing inappropriate barriers to accessing care.

(3) Educating and informing managed care plans of the specific needs of Medi-Cal beneficiaries.

(4) Educating beneficiaries on how to use the managed care system effectively.

Notes

Cal. Code Regs. Tit. 22, § 53893

1. New section filed 7-1-96 as an emergency; operative 7-1-96. Submitted to OAL for printing only pursuant to Section 147, SB 485 (Ch. 722/92) (Register 96, No. 28).
2. Repealer of section heading, section and NOTE and new section heading, 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 10950 through 10965, 14087.3, 14087.4 and 14450, Welfare and Institutions Code.

1. New section filed 7-1-96 as an emergency; operative 7-1-96. Submitted to OAL for printing only pursuant to Section 147, SB 485 (Ch. 722/92) (Register 96, No. 28).
2. Repealer of section heading, section and Note and new section heading, 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).