reglab/housing_qa huggingface dataset:
CA Welf & Inst Code § 14129.6 (2021)
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 3.91 - Medi-Cal Emergency Medical Transportation Reimbursement Act|Section 14129.6.

14129.6.  (a) (1) The department shall request any approval from the federal Centers for Medicare and Medicaid Services it deems necessary for the use of fees pursuant to this article and for the purpose of receiving associated federal matching funds.(2) In making that request, the department may seek, as it deems necessary, a request for waiver of the broad-based requirement, waiver of the uniformity requirement, or both, pursuant to paragraphs (1) and (2) of subdivision (e) of Section 433.68 of Title 42 of the Code of Federal Regulations, or a request for waiver of any other provisions of federal law or regulation necessary to implement this article.(3) This article shall be implemented only to the extent that any necessary federal approvals are obtained and federal financial participation is available and is not otherwise jeopardized.(b) The director may modify or make adjustments to any methodology, fee amount, or other provision specified in this article to the extent necessary to meet the requirements of federal law or regulations or to obtain federal approval. If the director, after consulting with affected emergency medical transport providers, determines that a modification is needed, the director shall execute a declaration stating that this determination has been made and that the actual or projected available fee amount for a state fiscal year remains approximately equal to the actual or projected aggregate fee schedule amount for each applicable state fiscal year, as defined by paragraph (4) of subdivision (b) of Section 14129.2. The director shall retain the declaration and provide a copy, within five working days of the execution of the declaration, to the fiscal and appropriate policy committees of the Legislature.(c) The director may add categories of exempt emergency medical transport providers or apply a nonuniform fee per transport to emergency medical transport providers that are subject to the fee in order to meet requirements of federal law or regulations. The director may exempt categories of emergency medical transport providers from the fee if necessary to obtain federal approval.(d) If, before June 1 preceding the start of an applicable state fiscal year, the director finds that the implementation of this article is likely no longer a benefit to the General Fund for the applicable state fiscal year, the director may decide to not implement this article for that state fiscal year. The director shall notify the appropriate fiscal and policy committees of the Legislature, and emergency medical transport providers individually and via the department’s Internet Web site of its finding pursuant to this subdivision.(Added by Stats. 2017, Ch. 773, Sec. 2. (SB 523) Effective October 13, 2017. Conditionally inoperative as prescribed in Section 14129.7. Repealed conditionally as provided in Section 14129.7.)
CA Welf & Inst Code § 14131 (2021)
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 14131.

14131.  The Medi-Cal Benefits Program comprises a department-administered uniform schedule of health care benefits. Notwithstanding any other provision of this chapter, “health care services” shall be limited to the benefits set forth in this article and in Section 14021.(Amended by Stats. 1975, Ch. 1005.)
CA Welf & Inst Code § 14131.15 (2021)
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 14131.15.

14131.15.  (a) In geographic areas in which Medi-Cal managed care plans contracting under this chapter or Chapter 8 (commencing with Section 14200) are operating with capacity to enroll additional qualifying Medi-Cal beneficiaries, the director may, in the interest of bringing managed care principles to bear on the quality, costs, or utilization levels of the Medi-Cal program, designate any benefit or service included in the Medi-Cal program, at state option under federal medicaid rules, as a covered Medi-Cal benefit only when provided by a Medi-Cal managed care plan to a Medi-Cal enrollee of the plan.(b) Where benefits and services have been designated by the director under subdivision (a), beneficiaries who are eligible to enroll in and reside in the service area of a managed care plan, and who desire coverage for such benefits and services, must enroll in a Medi-Cal managed care plan to receive them and shall, to the maximum extent permitted under federal law, remain enrolled in the plan.(c) When managed care capacity is reached in an area in which Medi-Cal benefits have been designated under this section, the director may provide for the delivery of designated benefits or services to beneficiaries by contract to the extent permitted under this chapter, on a fee-for-service basis or a combination of both.(d) Exercise of the director’s discretion under this section shall not preclude Medi-Cal managed care contractors from applying their established medical necessity criteria, utilization control standards and policies and utilization review procedures in delivering designated services as permitted and controlled by Medi-Cal contract and other state and federal regulatory standards.(e) Enactment of this section shall not impose any requirement on a Medi-Cal managed care plan to negotiate or enter into a contract or any other participation arrangement with any provider of a Medi-Cal benefit or service designated under subdivision (a).(f) The department shall seek all federal waivers necessary to allow for federal financial participation in expenditures under this section.(Added by Stats. 1992, Ch. 722, Sec. 120. Effective September 15, 1992.)
CA Welf & Inst Code § 14132.03 (2021)
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 14132.03.

14132.03.  (a) The following shall be covered Medi-Cal benefits effective January 1, 2014:(1) Mental health services included in the essential health benefits package adopted by the state pursuant to Section 1367.005 of the Health and Safety Code and Section 10112.27 of the Insurance Code and approved by the United States Secretary of Health and Human Services under Section 18022 of Title 42 of the United States Code. To the extent behavioral health treatment services are considered mental health services pursuant to the essential health benefits package, these services shall only be provided to individuals who receive services through federally approved waivers or state plan amendments pursuant to the Lanterman Developmental Disability Services Act, at Division 4.5 (commencing with Section 4500).(2) Substance use disorder services included in the essential health benefits package adopted by the state pursuant to Section 1367.005 of the Health and Safety Code and Section 10112.27 of the Insurance Code and approved by the United States Secretary of Health and Human Services under Section 18022 of Title 42 of the United States Code.(b) The department may seek approval of any necessary state plan amendments to implement this section.(c) This section shall be implemented only to the extent that federal financial participation is available and any necessary federal approvals have been obtained.(Added by Stats. 2013, 1st Ex. Sess., Ch. 4, Sec. 29. (SB 1 1x) Effective September 30, 2013.)
CA Welf & Inst Code § 14132.05 (2021)
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 14132.05.

14132.05.  The department shall provide the fiscal and appropriate policy committees of the Legislature with a copy of their submittal to the federal Health Care Financing Administration pertaining to any evaluation completed regarding the Family PACT federal waiver required by subdivision (aa) of Section 14132.(Added by Stats. 2000, Ch. 93, Sec. 90. Effective July 7, 2000.)
CA Welf & Inst Code § 14132.07 (2021)
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 14132.07.

14132.07.  (a) A Medi-Cal managed care plan shall not restrict the choice of the qualified provider from whom a beneficiary enrolled in the managed care plan may receive family planning services covered by the Medi-Cal program pursuant to subdivision (n) of Section 14132.(b) The following definitions shall apply for purposes of this section:(1) “Medi-Cal managed care plan” means an applicable organization or entity that contracts with the department to provide services to enrolled Medi-Cal beneficiaries pursuant to any of the following:(A) Article 2.7 (commencing with Section 14087.3).(B) Article 2.8 (commencing with Section 14087.5).(C) Article 2.81 (commencing with Section 14087.96).(D) Article 2.82 (commencing with Section 14087.98).(E) Article 2.91 (commencing with Section 14089).(F) Chapter 8 (commencing with Section 14200).(2) “Qualified provider” means a provider that is licensed to furnish family planning services, is an enrolled Medi-Cal provider, and is willing to furnish family planning services to an enrollee. A qualified provider may be an out-of-plan or out-of-network provider.(c) A Medi-Cal managed care plan shall reimburse an out-of-plan or out-of-network qualified provider at the applicable fee-for-service rate.(d) If federal approval is required to implement this section, the section shall be implemented only to the extent that federal approval is obtained.(Added by Stats. 2017, Ch. 572, Sec. 3. (SB 743) Effective January 1, 2018.)
CA Welf & Inst Code § 14132.1 (2021)
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 14132.1.

14132.1.  As used in this chapter “surgical center” means a surgical clinic that is licensed under Section 1203 of the Health and Safety Code. Pursuant to Section 14105, the director shall establish the rates of payment for services provided by surgical centers.(Amended by Stats. 1982, Ch. 328, Sec. 36. Effective June 30, 1982.)
CA Welf & Inst Code § 14132.10 (2021)
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 14132.10.

14132.10.  (a) (1) Pediatric day health care provided by a health facility licensed under paragraph (11) of subdivision (a) of Section 1250.1 of the Health and Safety Code is a covered benefit under this chapter subject to terms, conditions, and utilization controls developed by the department. Pediatric day health care does not include inpatient long-term care or family respite care.(2) Pediatric day health care services may be provided at any time of the day and on any day of the week, so long as the total number of authorized hours is not exceeded. Pediatric day health care services may be covered for up to 23 hours per calendar day.(b) The department shall publish emergency regulations for pediatric day health care services by October 1, 1997. These regulations shall reimburse providers at a rate that shall be determined by the department, consistent with efficiency, economy, and quality of care until a new rate is determined on the basis of a cost study conducted by the department.(c) Coverage for pediatric day health care services shall be available only to the extent that no additional net program costs are incurred.(d) The department shall not approve a request for authorization of pediatric day health care when the beneficiary for whom the authorization is requested is an inpatient in a licensed health care facility.(e) The department shall not approve a request for authorization of pediatric day health care if the department determines that the total cost incurred by the Medi-Cal program for providing pediatric day health care services and all other medically necessary services to the individual beneficiary is greater than the total cost incurred by the Medi-Cal program in providing medically equivalent services at the beneficiary’s otherwise appropriate level of institutional or home care.(f) Coverage for pediatric day health care services shall be available only to the extent that federal financial participation in the cost of providing these services is available pursuant to a federally approved state plan amendment including those services as a Medi-Cal program benefit.(Amended by Stats. 2019, Ch. 64, Sec. 1. (AB 781) Effective January 1, 2020.)
CA Welf & Inst Code § 14132.101 (2021)
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 14132.101.

14132.101.  (a) Notwithstanding paragraphs (4) and (5) of subdivision (e) of Section 14132.100, a scope-of-service change request, whether mandatory or permissive, shall be timely when filed within 150 days following the beginning of the federally qualified health center’s or rural health clinic’s fiscal year following the year in which the change occurred.(b) Notwithstanding subdivision (a), and notwithstanding subdivision (e) of Section 14132.100, a federally qualified health center described in Section 14132.102 shall be deemed to have filed a scope-of-service change in a timely manner upon compliance with the requirements set forth in subdivision (c) of Section 14132.102.(Added by Stats. 2005, Ch. 548, Sec. 1. Effective January 1, 2006.)
CA Welf & Inst Code § 14132.107 (2021)
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 14132.107.

14132.107.  Claims for reimbursement under subdivision (e) of Section 14132.100 shall be finalized by the department within 150 days of receipt of the claims for reimbursement. These claims for reimbursement shall be paid within 30 days of being finalized by the department. However, the payment of those amounts that are disputed shall be subject to the requirements, timeframes, and procedures specified in Section 14171. Scope changes going forward shall be finalized within 90 days of receipt and paid within 30 days of being finalized by the department.(Added by Stats. 2004, Ch. 228, Sec. 21. Effective August 16, 2004.)
CA Welf & Inst Code § 14132.108 (2021)
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 14132.108.

14132.108.  Notwithstanding any other provision of law, requests for rate adjustments for scope-of-service rate changes under paragraph (4) of subdivision (e) of Section 14132.100 for an FQHC’s or RHC’s fiscal year ending in 2004 shall be deemed to have been filed in a timely manner so long as it is filed within 90 days following the end of the 150-day timeframe applicable to scope-of-service changes occurring from January 1, 2001, to the end of an FQHC’s or RHC’s 2003 fiscal year, as specified in paragraph (6) of subdivision (e) of Section 14132.100.(Added by Stats. 2004, Ch. 228, Sec. 22. Effective August 16, 2004.)
CA Welf & Inst Code § 14132.15 (2021)
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 14132.15.

14132.15.  For purposes of subdivision (p) of Section 14132, “rehabilitation services” means services intended to assist physically or cognitively impaired persons to achieve or regain their maximum functional potential for mobility, self-care, and independent living.(Added by Stats. 1985, Ch. 1360, Sec. 2.)
CA Welf & Inst Code § 14132.16 (2021)
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 14132.16.

14132.16.  Mammography for screening or diagnostic purposes upon the referral of a patient’s physician shall be covered under this chapter on or after January 1, 1988, to the extent required or permitted by federal law.(Added by Stats. 1987, Ch. 550, Sec. 4.)
CA Welf & Inst Code § 14132.17 (2021)
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 14132.17.

14132.17.  Annual cervical cancer tests for screening or diagnostic purposes, upon the referral of a patient’s physician, is a covered benefit under this chapter, on or after January 1, 1991, to the extent required or permitted by federal law.(Added by Stats. 1990, Ch. 1279, Sec. 4.)
CA Welf & Inst Code § 14132.195 (2021)
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 14132.195.

14132.195.  (a) Consistent with federal law, screening services provided as an Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit pursuant to subdivision (v) of Section 14132 shall include developmental screening services for individuals zero to three years of age, inclusive.(b) Medi-Cal managed care plans shall ensure, and monitor compliance with, both of the following:(1) Developmental screening services provided by providers who contract with Medi-Cal managed care plans comply with the periodicity schedule and the standardized and validated developmental screening tools that are established by the Bright Futures Guidelines and Recommendations for Preventive Pediatric Health Care, as established by the American Academy of Pediatrics, and by any future updates to this material.(2) Developmental screening tools administered by providers who contract with Medi-Cal managed care plans are administered in their entirety, and in adherence to, the specific tools’ recommended guidelines.(c) This section does not limit or restrict the scope of the EPSDT benefit, as required to be provided to eligible Medi-Cal beneficiaries under 21 years of age pursuant to Section 1396d(r) of Title 42 of the United States Code.(d) This section does not limit or restrict blood lead screenings required under Chapter 5 (commencing with Section 105275) of Part 5 of Division 103 of the Health and Safety Code.(Added by Stats. 2019, Ch. 387, Sec. 2. (AB 1004) Effective January 1, 2020.)
CA Welf & Inst Code § 14132.21 (2021)
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 14132.21.

14132.21.  The department shall assess the feasibility of applying to the federal Health Care Financing Administration for a Medicaid State Plan amendment to provide targeted case management to pregnant substance-abusing women and women who have given birth to a drug-exposed or alcohol-exposed infant. These women may be identified through self-referral, family planning or health clinics, public or private hospitals, drug treatment programs, the Medi-Cal program, or other public assistance or health treatment programs. Women eligible for services under the targeted case management program would be provided the following case management services:(a) Intake and service needs assessment of women currently receiving Medi-Cal benefits.(b) Development of a coordinated health and treatment plan for the eligible woman and her infant, listing needed services.(c) Case management services to assist with gaining access to needed medical, social, educational, and other services.(d) Referral to any of the following programs that are listed in the woman’s health and treatment plan:(1) Child Health and Disability Prevention Program.(2) Supplementary Food Program for Women, Infants, and Children (WIC).(3) Drug abuse treatment and detoxification programs.(4) In-home support services to enhance the woman’s utilization of drug treatment programs, and prenatal and perinatal care services.(5) Transportation to health and drug treatment services.(6) Crisis assistance to address health and drug treatment needs.(7) Other case management services authorized by the federal Health Care Financing Administration.(Amended by Stats. 2013, Ch. 22, Sec. 103. (AB 75) Effective June 27, 2013. Operative July 1, 2013, by Sec. 110 of Ch. 22.)
CA Welf & Inst Code § 14132.22 (2021)
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 14132.22.

14132.22.  (a) For purposes of this section, dental restorative materials are limited to composite resin, glass ionomer cement, resin ionomer cement, and amalgam, as described on the Dental Board of California’s dental materials factsheet.(b) A provider of services that includes the provision of dental restorative materials to a beneficiary under this chapter may recommend, after consultation with the beneficiary, a dental restorative material other than the covered benefit of amalgam.(c) A provider may claim and receive the reimbursement rate for an amalgam restoration when using a different dental restorative material.(Amended by Stats. 2004, Ch. 183, Sec. 386. Effective January 1, 2005.)
CA Welf & Inst Code § 14132.23 (2021)
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 14132.23.

14132.23.   (a) (1) Except as set forth in paragraph (2), and notwithstanding any other provision of law or regulation, the active and retentive phases of orthodontic treatment covered under the Medi-Cal program shall be reimbursed on a quarterly basis, as determined by dividing the sum of the authorized treatment allowances by the estimated number of three-month periods that the patient’s treatment will require, subject to the department’s utilization controls.(2) The retentive phase of orthodontic treatment shall be reimbursed pursuant to paragraph (1) only until the department implements the Code on Dental Procedures and Nomenclature, as published by the American Dental Association in its Current Dental Terminology manual, at which time paragraph (1) shall not apply to retentive phase orthodontic services that are covered under the Medi-Cal program.(b) This section shall become operative on July 1, 2008.(Added by Stats. 2007, Ch. 494, Sec. 1. Effective January 1, 2008. Section operative July 1, 2008, by its own provisions.)