Cal. Code Regs. Tit. 22, § 53926 - Problem Resolution Process for Members

(a) Any member may request assistance from the GMC enrollment contractor in resolving problems associated with mandatory participation in the GMC program, assignment to a GMC plan, enrollment, or disenrollment.

(b) The request for assistance from the GMC enrollment contractor shall be in writing and shall state the nature of a problem.

(c) The GMC enrollment contractor shall prepare a written response and mail it to the member within ten days of receipt of a member's written request for problem resolution.

(d) In the event a member is dissatisfied with the response of the GMC enrollment contractor to a request for problem resolution, the member may file an appeal with the department.

(1) The member shall submit to the department the information specified in (b) and the written response of the GMC enrollment contractor.

(2) The department shall prepare a written decision and mail it to the member within ten days of receipt of a member's appeal.

(e) Each member has the right to request a fair hearing, in accordance with Section 50951.

Notes

Cal. Code Regs. Tit. 22, § 53926

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 10950, 14089, 14089.2 and 14450, 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).