2021 California Code
Welfare and Institutions Code - WIC
DIVISION 9 - PUBLIC SOCIAL SERVICES
PART 3 - AID AND MEDICAL ASSISTANCE
CHAPTER 7 - Basic Health Care
ARTICLE 4 - The Medi-Cal Benefits Program
Section 14133.05.
(a) Notwithstanding any other provision of law, a request for a treatment authorization received by the department shall be reviewed for medical necessity only.
(b) Any claim for a service that is authorized pursuant to a treatment authorization request that qualifies for approval under the requirements established by the department in regulations shall be reduced in accordance with Section 14115.
(c) If a provider does not agree with the decision on a treatment authorization request, the provider may appeal the decision pursuant to procedures set forth in regulations adopted by the department.
(d) Providers shall comply with the administrative remedies available to them prior to seeking a judicial remedy with respect to a decision of the department on a treatment authorization request.
(Added by Stats. 2000, Ch. 93, Sec. 95. Effective July 7, 2000.)
