reglab/housing_qa huggingface dataset:
CA Welf & Inst Code § 16953.1 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 3.5 - Physician Services Account|Section 16953.1.

16953.1.  Notwithstanding any other provision of this chapter, an emergency physician and surgeon, or an emergency physician group, with a gross billings arrangement with a hospital shall be entitled to receive reimbursement from the physician services account in the county’s emergency medical services fund for services provided in that hospital, if all of the following conditions are met:(a) The services are provided in a basic or comprehensive general acute care hospital emergency department. (b) The physician and surgeon is not an employee of the hospital. (c) All provisions of Section 16955 are satisfied, except that payment to the emergency physician and surgeon, or an emergency physician group, by a hospital pursuant to a gross billings arrangement shall not be interpreted to mean that payment for a patient is made by a responsible third party. (d) Reimbursement from the physician services account in the county’s emergency medical services fund is sought by the hospital or the hospital’s designee, as the billing and collection agent for the emergency physician and surgeon, or an emergency physician group. (e) For purposes of this section, “gross billings arrangement” means an arrangement whereby a hospital serves as the billing and collection agent for the emergency physician and surgeon, or an emergency physician group, and pays the emergency physician and surgeon, or an emergency physician group, a percentage of the emergency physician and surgeon’s or group’s gross billings for all patients.(Amended by Stats. 1991, Ch. 278, Sec. 20. Effective July 30, 1991.)
CA Welf & Inst Code § 16953.2 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 3.5 - Physician Services Account|Section 16953.2.

16953.2.  Nothing in this article shall prevent a physician from utilizing an agent who furnishes billing and collection services to the physician to submit claims or receive payment for claims.(Added by Stats. 1991, Ch. 278, Sec. 21. Effective July 30, 1991.)
CA Welf & Inst Code § 16953.3 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 3.5 - Physician Services Account|Section 16953.3.

16953.3.  (a) Notwithstanding any other restrictions on reimbursement, a county shall adopt a fee schedule to establish a uniform, reasonable level of reimbursement from the Physician Services Account for reimbursable services.(b) (1) Notwithstanding any other restrictions on reimbursement, the State Department of Public Health shall adopt a single fee schedule to establish a uniform, reasonable level of reimbursement for use in the physician services reimbursement programs operated by the department pursuant to contract, as provided for in subdivision (c) of Section 16952.(2) The State Department of Public Health may develop, contract for the development of, or adopt by reference, the fee schedule required by paragraph (1).(3) Pursuant to subdivision (d) of Section 16952, the State Department of Public Health may be reimbursed by the Physician Services Account and the Hospital Services Account based on actual administrative costs to develop or adopt the fee schedule required by paragraph (1), not to exceed 10 percent of the amount of the account.(4) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this subdivision by means of provider bulletins, or similar instruction, without taking formal regulatory action.(Amended by Stats. 2007, Ch. 483, Sec. 53. Effective January 1, 2008.)
CA Welf & Inst Code § 16955 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 3.5 - Physician Services Account|Section 16955.

16955.  Reimbursement for losses incurred by any physician shall be limited to services provided to a patient as established by subdivisions (f) and (g) of Section 16952, and where all of the following conditions have been met:(a) The physician has inquired if there is a responsible third-party source of payment.(b) The physician has billed for payment of services.(c) Either of the following:(1) A period of not less than three months has passed from the date the physician billed the patient or responsible third party, during which time the physician has made reasonable efforts to obtain reimbursement and has not received reimbursement for any portion of the amount billed.(2) The physician has received actual notification from the patient or responsible third party that no payment will be made for the services rendered by the physician.(d) The physician has stopped any current, and waives any future, collection efforts to obtain reimbursement from the patient, upon receipt of funds from the county physician services account in the county emergency medical services fund.(Amended by Stats. 2005, Ch. 671, Sec. 9. Effective January 1, 2006.)
CA Welf & Inst Code § 16955.1 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 3.5 - Physician Services Account|Section 16955.1.

16955.1.  This article shall not be applied or interpreted so as to prevent a physician from seeking payment from a patient or responsible third-party payor, or arranging a repayment schedule for the costs of services rendered prior to receiving payment under this article.(Added by Stats. 1990, Ch. 51, Sec. 42. Effective April 18, 1990.)
CA Welf & Inst Code § 16956 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 3.5 - Physician Services Account|Section 16956.

16956.  (a) The administering agency shall establish procedures and time schedules for submission and processing of reimbursement claims submitted by physicians in accordance with this chapter.(b) Schedules for payment established in accordance with this section shall provide for disbursement of the funds available in the account periodically and at least quarterly, if funds remain available for disbursement, to all physicians who have submitted claims containing accurate and complete data for payment by the dates established by the administering agency.(c) Claims which are not supported by records may be denied by the administering agency, and any reimbursement paid in accordance with this chapter to any physician which is not supported by records shall be repaid to the administering agency, and shall be a claim against the physician.(d) Any physician who submits any claim for reimbursement under this chapter which is inaccurate or which is not supported by records may be excluded from reimbursement of future claims under this chapter.(e) A listing of patient names shall accompany a physician’s claim, and those names shall be given full confidentiality protections by the administering agency.(f) The administering agency shall not give preferential treatment to any facility, physician, or category of physician and shall not engage in practices that constitute a conflict of interest by favoring a facility or physician with which the administering officer has an operational or financial relationship.(g) Payments shall be made only for emergency medical services provided on the calendar day on which emergency medical services are first provided and on the immediately following two calendar days.(h) Notwithstanding subdivision (g), if it is necessary to transfer the patient to a second facility that provides for a higher level of care for the treatment of the emergency condition, reimbursement shall be available for services provided to the facility to which the patient was transferred on the calendar day of transfer and on the immediately following two calendar days.(Amended by Stats. 2005, Ch. 671, Sec. 10. Effective January 1, 2006.)
CA Welf & Inst Code § 16956.5 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 3.5 - Physician Services Account|Section 16956.5.

16956.5.  (a) The administering agency may establish an EMS Fund advisory committee. The committee shall include emergency physicians and emergency department oncall backup panel physicians. The committee shall advise the administering agency regarding distribution of funds pursuant to this section.(b) If the administering agency establishes a committee pursuant to subdivision (a) and the committee, upon an affirmative vote by every member of the committee, recommends that the administering agency adopt a special fee schedule and claims submission criteria for reimbursement for services rendered to uninsured trauma patients, the administering agency may adopt the special fee schedule and claims submission criteria.(c) Notwithstanding any provision of law to the contrary, in addition to reimbursement for trauma service rendered in the initial day and the following two calendar days, the administering agency may reimburse pursuant to this section for services rendered to uninsured trauma patients beyond the calendar day on which emergency medical services are first provided and the immediately following two calendar days.(d) Only up to 15 percent of the tobacco tax revenues allocated to the county’s EMS Fund may be distributed through this special fee schedule.(e) All providers who render services to uninsured trauma patients may submit claims for reimbursement under this section. No provider’s claim shall be initially reimbursed pursuant to this section at greater than 50 percent of losses.(Added by Stats. 2005, Ch. 671, Sec. 11. Effective January 1, 2006.)
CA Welf & Inst Code § 16957 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 3.5 - Physician Services Account|Section 16957.

16957.  Any physician who submits any claim in accordance with this chapter shall keep and maintain records of the services rendered, the person to whom services were rendered, and any additional information the administering agency may require, for a period of three years after the services were provided.(Added by Stats. 1989, Ch. 1331, Sec. 9. Effective October 2, 1989.)
CA Welf & Inst Code § 16958 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 3.5 - Physician Services Account|Section 16958.

16958.  If, after receiving payment from the account, a physician is reimbursed by a patient or a responsible third-party, the physician shall do one of the following:(a) Notify the administering agency and the administering agency shall reduce the physician’s future payment of claims from the account . In the event there is not a subsequent submission of a claim for reimbursement within one year, the physician shall reimburse the account in an amount equal to the amount collected from the patient or third-party payor, but not more than the amount of reimbursement received from the account.(b) Notify the administering agency of the payment and reimburse the account in an amount equal to the amount collected from the patient or third-party payor, but not more than the amount of the reimbursement received from the account for that patient’s care.(Amended by Stats. 1990, Ch. 51, Sec. 43. Effective April 18, 1990.)
CA Welf & Inst Code § 16959 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 3.5 - Physician Services Account|Section 16959.

16959.  The moneys contained in a Physician Services Account within an Emergency Medical Services Fund shall not be subject to Chapter 2.5 (commencing with Section 1797.98a) of Division 2.5 of the Health and Safety Code.(Added by Stats. 1991, Ch. 1169, Sec. 5.)
CA Welf & Inst Code § 16960 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 4 - Other County Health Services|Section 16960.

16960.  (a) Twenty-eight and three-tenths percent, or that percentage of the program account deriving from the Unallocated Account of the fund in a fiscal year of each MISP county’s allocation under Section 16941, shall be expended consistent with Article 2 (commencing with Section 30121) of Chapter 2 of Part 13 of Division 2 of the Revenue and Taxation Code, at county discretion, to maintain and enhance health care services provided on or after July 1, 1989, for patients who cannot pay for those services which will not be covered by private insurance or by a program funded in whole or in part by the federal government. In those MISP counties where city public health departments exist, the county shall give consideration to those agencies in the use of funds received pursuant to this section.(b) Counties may expend up to 5 percent or fifty thousand dollars ($50,000), whichever is greater, of the funds received pursuant to this section for costs related to the purchase of equipment and fixed assets. However, no single expenditure may exceed ten thousand dollars ($10,000).(Amended by Stats. 1990, Ch. 51, Sec. 44. Effective April 18, 1990.)
CA Welf & Inst Code § 16961 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 4 - Other County Health Services|Section 16961.

16961.  Services provided pursuant to this article include only those health care services specified in Sections 14021 and 14132, and former Division 1 (commencing with Section 100), and the Communicable Disease Prevention and Control Act as set forth in subdivision (a) of Section 27, of the Health and Safety Code, which are provided to patients who cannot afford to pay for those services, and for whom payment will not be made through private coverage or by any program funded in whole or in part by the federal government.(Amended by Stats. 1996, Ch. 1023, Sec. 495. Effective September 29, 1996.)
CA Welf & Inst Code § 16970 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 5 - Child Health and Disability Prevention|Section 16970.

16970.  (a) As a condition of receiving funds under this chapter, a county shall provide, or arrange and pay for, medically necessary followup treatment, including necessary followup dental treatment and prescription drugs, for any condition detected as part of a child health and disability prevention screen for any child eligible for services under Section 104395 of the Health and Safety Code if the child was screened by the county or upon referral by a child health and disability prevention program provider, unless the child is eligible to receive care with no share of cost under the Medi-Cal program or is covered under another publicly funded program, or the services are payable under private insurance coverage.(b) A county may require that hospitals, physicians, dentists, and other providers receiving funds appropriated pursuant to this part participate in complying with this section, provided that:(1) Hospitals that receive an allocation pursuant to paragraph (1) of subdivision (b) of Section 16946 and physicians who receive payment from the Physician Services Account of the emergency medical services fund established pursuant to Article 3.5 (commencing with Section 16951) shall not be required to participate in complying with subdivision (a) as a condition of receiving those allocations or payments.(2) Only providers that contract with the county and receive funds disbursed from the Unallocated Account pursuant to Article 4 (commencing with Section 16960) or from the discretionary portion of the Physician Services Account pursuant to subdivision (b) of Section 16950, or from the discretionary portion of the Hospital Services Account pursuant to paragraph (2) of subdivision (b) of Section 16946 may be required to participate in complying with subdivision (a).(c) Dental services provided pursuant to this section shall be at least equal in scope and frequency to dental services available to Medi-Cal eligible children of the same age.(d) Counties shall implement this section in consultation and coordination with their child health disability prevention programs.(Amended by Stats. 1996, Ch. 1023, Sec. 496. Effective September 29, 1996.)
CA Welf & Inst Code § 16980 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 6 - County Application|Section 16980.

16980.  (a) The department shall make initial monthly payments of county allocations made pursuant to Section 16941 upon application of the county assuring that it will comply with the provisions of this part. Payments shall be made on a monthly basis. Payments made beyond February 15 of each fiscal year, shall be contingent upon the signing of an agreement between the county board of supervisors and the department.(b) (1) Each county shall submit a report of expenditures and other information to the department according to procedures established by the department. The department shall review the report submitted pursuant to this paragraph and recoup unspent moneys, or any expenditures that are not in compliance with this chapter or the requirements established pursuant to Section 16990.(2) Beginning with the 1990–91 fiscal year, each county shall include an estimate of, and the costs and funding arrangement for, dental services in its information submitted pursuant to paragraph (1).(Amended by Stats. 1994, Ch. 195, Sec. 48. Effective July 12, 1994.)
CA Welf & Inst Code § 16981 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 6 - County Application|Section 16981.

16981.  (a) The department shall conduct fiscal and program reviews to ensure county compliance with the provisions of this part, and shall report annually the results of these reviews to the Legislature. The department may withhold funds, up to the total amount of funds allocated under this chapter, if a county fails to correct deficiencies in the program after receiving written notice of noncompliance from the department.(b) The department shall recoup funds which were provided pursuant to this chapter and Chapter 4 (commencing with Section 16930) if they were not encumbered or expended according to the requirements of this chapter or Chapter 4 respectively within the fiscal year according to procedures and reports required by the department. The funds shall revert to the CHIP Account or Rural Health Services Account respectively.(Amended by Stats. 1994, Ch. 195, Sec. 49. Effective July 12, 1994.)
CA Welf & Inst Code § 16990.1 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 7 - Financial Maintenance of Effort|Section 16990.1.

16990.1.  Notwithstanding the first sentence of paragraph (1) of subdivision (a) of Section 16990, for the purposes of determining the level of financial support in the 1996–97 fiscal year, the amounts specified in subparagraph (A) of paragraph (1) of subdivision (a) of Section 16990 shall be added to 50 percent of the amounts specified in subparagraph (B) of paragraph (1) of subdivision (a).(Added by Stats. 1996, Ch. 199, Sec. 17. Effective July 22, 1996.)
CA Welf & Inst Code § 16990.9 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 7 - Financial Maintenance of Effort|Section 16990.9.

16990.9.  The level of financial maintenance of effort required of a county that contracts with the department pursuant to Section 101300 of the Health and Safety Code during the 1991–92, 1992–93, 1993–94, 1994–95, and subsequent fiscal years may be reduced by the amount of local public health service funds retained by the county for that fiscal year that are unexpended as a result of vacant contracted positions.(Amended by Stats. 1996, Ch. 1023, Sec. 497. Effective September 29, 1996.)
CA Welf & Inst Code § 16995 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 10 - Eligibility and Benefit Requirements|Section 16995.

16995.  Funds received by a county pursuant to this chapter shall not be used to support health services provided to persons detained in a county or city jail or other correctional facility.(Amended by Stats. 1992, Ch. 719, Sec. 11. Effective September 15, 1992.)
CA Welf & Inst Code § 16995.1 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 4.7 - HEALTH CARE FOR INDIGENTS|CHAPTER 5 - California Healthcare for Indigents Program|ARTICLE 10 - Eligibility and Benefit Requirements|Section 16995.1.

16995.1.  Receipt of funding pursuant to this chapter shall not relieve a county of its obligation to provide indigent health care as required by Section 17000.(Added by Stats. 1989, Ch. 1331, Sec. 9. Effective October 2, 1989.)