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Summary:

(a) Health care service plans must provide a grievance system for enrollees. The plan must maintain a log of the grievances, including the date, name of complainant, member ID, and nature of the grievance and resolution. The plan must maintain in its files all grievances and responses for five years. (b) After 30 days of participation in the insurance plan's grievance process, enrollees can submit their grievance to the Department of Managed Health Care for review. The department may refer any grievance that does not pertain to compliance with this chapter to the State Department of Public Health, the California Department of Aging, the federal Health Care Financing Administration, or any other appropriate governmental entity for investigation and resolution. If the subscriber or enrollee is a minor, or incompetent or incapacitated, the parent, guardian, conservator, relative, or other designee of the subscriber/enrollee, may submit the grievance to the department as the subscriber/enrollee's agent. The department must send written notice of the final disposition of the grievance to the enrollee within 30 days of receipt of the request for review, unless the director determines that additional time is reasonably necessary to fully evaluate the grievance. (c) The plan's grievance system shall include a system of aging of grievances that are pending and unresolved for 30 days or more. The plan shall provide a quarterly report to the Director of the Department of Managed Health Care about such pending/unresolved grievances, with separate categories of grievances for Medicare enrollees and Medi-Cal enrollees. The plan shall include with the report a brief explanation of the reasons each grievance is pending and unresolved for 30 days or more.

Summary:

The medical director of each state hospital for the mentally disordered must make a roster of the gravely disabled persons within the institution. Officer in charge of investigating conservatorships within a county shall be provided with the names and pertinent records of patients to be provided conservatorship investigation.

Summary:

The medical director should immediately forward the records of patients voluntarily admitted to a state hospital for mental disorder or developmental disability to the State Department of Mental Health or the State Department of Developmental services.

Summary:

Every health care service plan shall, upon request, provide to enrollees and subscribers a written statement that describes: how it protects confidential medical information; types of medical information it collects; purposes for which it collects the info; when the information may be disclosed without prior authorization; and how patients may obtain access to this information.

Keywords:
enrollee
Summary:

An employer that is a provider of health care (or its agent) shall not be deemed to have violated Civil Code 56.20 if it follows the requirements for disclosing medical information possessed in connection with providing health care services to the provider's patients or employing its own employees.

Summary:

State hospitals for the developmentally disabled and mentally disordered shall notify parents that their child can be considered for off-site educational programs. Records concerning state hospital patients shall be confidential.

Summary:

Persons in charge of hospitals or other institutions where patients are admitted for treatment or confinement, must make a record of the patient's personal, medical, and other information adequate for the completion of a birth or death certificate.

Summary:

Except as per 123115 and 123120, patients, minor patients authorized to consent to medical treatment, and any patient representatives shall be entitled to inspect patient records upon written request and payment of clerical costs. Such persons shall also be entitled to copies of patient records. Health care providers are prohibited from withholding patient records because of unpaid bills.

Summary:

Noncounty hospitals receiving funds pursuant to 16946(b)(1), must report to the county within 30 days of receiving the funds, information on patients for whom the funds were used pursuant to 16918.

Summary:

Notwithstanding the general confidentiality protections of Welf. & Inst. Code 5328, information and records shall be disclosed to county patients' rights advocates who have been given knowing voluntary authorization by a client or a guardian ad litem. The client or guardian ad litem, whoever entered into the agreement, may revoke the authorization at any time, either in writing or by oral declaration to an approved advocate.

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