Cal. Code Regs. Tit. 22, § 53904 - GMC Plan Requirements

(a) Each GMC plan shall:

(1) Agree to provide or arrange for the provision of, to the extent allowed by state and federal law, the scope of Medi-Cal program benefits set forth by GMC contract to eligible beneficiaries who either select or are assigned to that GMC plan.

(2) Share in the risk of providing health care services.

(3) Provide readily available and accessible health care services and utilize preventive health care programs to improve the health status of its members.

(4) Case manage members' utilization of health care services.

(5) Inform eligible beneficiaries about non-medical transportation services that may be available to them under the Medi-Cal program, including the conditions under which non-medical transportation services will be provided to members by the GMC plan and how a member is to request those services, if the plan opts to provide them.

Notes

Cal. Code Regs. Tit. 22, § 53904

1. New section filed 3-11-94; operative 3-11-94; Submitted to OAL for printing only pursuant to section 147, SB 485 (Chapter 722, Statutes of 1992) (Register 94, No. 15).

Note: Authority cited: Sections 10725, 14089.7, 14105, 14124.5, 14203 and 14312, Welfare and Institutions Code. Reference: Sections 14089 and 14089.4, Welfare and Institutions Code.

1. New section filed 3-11-94; operative 3-11-94; Submitted to OAL for printing only pursuant to section 147, SB 485 (Chapter 722, Statutes of 1992) (Register 94, No. 15).