Cal. Code Regs. Tit. 22, § 53923 - Options Presentation

(a) The GMC enrollment contractor shall provide a presentation of GMC plan options to each new and continuing eligible beneficiary who requests a presentation.

(b) The GMC options presentation shall include, at a minimum, the following information:

(1) The names of each GMC plan.

(2) Each GMC plan's service area.

(3) The locations of each GMC plan's service sites.

(4) Services covered by GMC plans.

(5) Procedures for accessing and receiving health care services from GMC plans.

(6) Hospitals used by each PHP and PCCM plan.

(7) Any features or additional services provided by each GMC plan that are beyond those that must be covered by GMC plans, pursuant to the GMC contract, such as non-medical transportation services, languages spoken, health promotion, risk reduction, health education and counseling services.

(8) An explanation that an alternative to GMC plan enrollment exists for Indians, members of Indian households, and others eligible to receive health care services through an Indian Health Service program facility, and for individuals with complex medical conditions, as specified in Section 53923.5(b).

(9) Assistance to eligible beneficiaries in completing the enrollment form, as needed.

Notes

Cal. Code Regs. Tit. 22, § 53923

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: Section 14089, 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).