reglab/statecodes huggingface dataset:
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 8 - Hospital Community Reports › Article 1 - 1. Hospital Supplier Diversity Reporting › Section 95000 - Definitions

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
For the purposes of this chapter, the following definitions
					 apply:
(a) "Director" means the
				  Director of the Department of Health Care Access and Information, as described
				  in Health and Safety Code section
				  127005.
(b) "Department" means the Department of
				  Health Care Access and Information.
(c) "Operating expenses" means total
				  patient-related operating expenses for the most recent fiscal year reported to
				  the Department on the Hospital Annual Financial Disclosure Report CHC 7041 d-1,
				  column 1, line 200, submitted as specified in Title 22, California Code of
				  Regulations, Section
				  97040.
(d) "Disabled Veteran Business Enterprise"
				  has the same meaning as defined in subparagraph (A) of paragraph (7) of
				  subdivision (b) of Section
				  999
				  of the Military and Veterans Code or any successor provision. Disabled veteran
				  business enterprise certification eligibility requirements shall be consistent
				  with the requirements imposed by the Department of General Services, and this
				  chapter shall only apply to a disabled veteran business enterprise certified by
				  the Department of General Services.
(e) "LGBT business enterprise" means
(1) a business enterprise (a) that is at
				  least 51 percent owned by a lesbian, gay, bisexual, or transgender person or
				  persons or (b) if a publicly owned business, at least 51 percent of the stock
				  of which is owned by one or more lesbian, gay, bisexual, or transgender
				  persons; and
(2) whose management
				  and daily business operations are controlled by one or more of those
				  individuals.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 8 - Hospital Community Reports › Article 1 - 1. Hospital Supplier Diversity Reporting › Section 95001 - Contact Registration

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Each hospital or hospital system/regional network must designate a primary
				  contact person and must register with the Department for the purpose of
				  receiving advanced notice of report due dates and to submit the required
				  report.
(b) A primary contact
				  person must register on the Department's website using the registration portal
				  at
https://hcai.ca.gov/data-and-reports/cost-transparency/hospital-supplier-diversity/
.
				  A contact person must provide the following information:
(1) The legal name of the hospital or
				  hospital system.
(2) The name of a
				  contact person designated to receive notices.
(3) The business title of the designated
				  contact person.
(4) A business
				  address.
(5) A business email
				  address.
(6) A business phone
				  number.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 8 - Hospital Community Reports › Article 1 - 1. Hospital Supplier Diversity Reporting › Section 95003 - System/Regional-Level Hospital Supplier Diversity Report (Optional)

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A hospital that is part of a hospital
				  system or is organized within a regional network within a hospital system may
				  report the diversity of its procurement in compliance with this subparagraph
				  from a systemwide or regional network level if there are suppliers that provide
				  services or goods to all hospitals within the hospital system or regional
				  network. A hospital shall report the diversity of the remainder of its
				  procurement, including the suppliers that do not resource the entire hospital
				  system or regional network, as an individual hospital.
(1) When submitting a system/regional-level
				  report, the report will only apply to the procurements purchased at a
				  system/regional-level. A hospital system may use diverse suppliers for the
				  hospitals within their own networks that would apply in this report.
(2) Individual hospital-level reports will
				  highlight procurement data purchased on an individual
				  level.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 8 - Hospital Community Reports › Article 1 - 1. Hospital Supplier Diversity Reporting › Section 95004 - Report Due Dates

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Each hospital shall annually update its supplier diversity report and submit
				  the new report to the office no later than July 1 of that year.
1. New
					 section filed 8-22-2022; operative 10-1-2022 (Register 2022, No.
					 34).
Note: Authority cited: Section
						127010,
						Health and Safety Code. Reference: Sections
						1339.86
						and
						1339.87,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 8 - Hospital Community Reports › Article 1 - 1. Hospital Supplier Diversity Reporting › Section 95005 - Extension Request

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A
				  hospital may request, and the Department may grant, a 30-day extension to file
				  the report if needed due to unintended or unforeseen delays.
(b) The registered contact person(s) of the
				  hospital may file with the Department a request for an extension of time to
				  file for this required report. A request for extension shall be filed on or
				  before the required due date, prescribed in Section
				  95004, by using the extension
				  request screen available through the Department's website using the report
				  submission portal at
https://hcai.ca.gov/data-and-reports/cost-transparency/hospital-supplier-diversity/
.
Notices regarding the use of extension days, and new due dates, as well as
				  notices of approval and rejection, will be e-mailed to the registered contact
				  person(s) provided.
(c) The
				  Department shall respond to an extension request with an email confirmation to
				  the requestor that their 30-day extension has been granted.
1. New
					 section filed 8-22-2022; operative 10-1-2022 (Register 2022, No.
					 34).
Note: Authority cited: Section
						127010,
						Health and Safety Code. Reference: Sections
						1339.86
						and
						1339.87,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 8 - Hospital Community Reports › Article 1 - 1. Hospital Supplier Diversity Reporting › Section 95006 - Method of Submission

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  A report required under Section
				  95002 shall be submitted to the
				  Department through the Department's website using the report submission portal
				  at
https://hcai.ca.gov/data-and-reports/cost-transparency/hospital-supplier-diversity/
.
(b) Reports must be submitted using one of
				  the following methods:
(1) Uploading comma
				  separated value (.csv) files including all of the required information for one
				  or more reports. Such files shall comply with the Department's Format and File
				  Specifications for Submission of Hospital Supplier Diversity Reports Version
				  1.0, dated December 31, 2021, and hereby incorporated by reference;
				  or
(2) Entering the required
				  information for reports online.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 8 - Hospital Community Reports › Article 1 - 1. Hospital Supplier Diversity Reporting › Section 95007 - Penalties for Late Filing of Reports

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A hospital that fails to file a required
				  report by the due date established by Section
				  95004 is liable for a civil
				  penalty of one hundred dollars ($100) for each day after the due date that the
				  required report is not filed.
(b)
				  If the report is delinquent at the time the next report is due, the Department,
				  on an annual basis, shall determine a maximum civil penalty of no more than
				  thirty-six thousand, five hundred dollars ($36,500) for failure to file a
				  required report.
1. New
					 section filed 8-22-2022; operative 10-1-2022 (Register 2022, No.
					 34).
Note: Authority cited: Section
						127010,
						Health and Safety Code; and Section
						1339.87,
						Health and Safety Code. Reference: Section
						1339.87,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 8 - Hospital Community Reports › Article 1 - 1. Hospital Supplier Diversity Reporting › Section 95008 - Penalty Assessment

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  When a report required by Section
				  95002 is filed after the due date
				  specified in Section
				  95004, the Department will notify
				  the hospital of the accrued penalty. The notice shall be provided by email to
				  the authorized individual identified by the hospital under subdivision (b)(2)
				  of Section
				  95001.
(b) The Department will calculate the accrued
				  penalty pursuant to Section
				  95007.
1. New
					 section filed 8-22-2022; operative 10-1-2022 (Register 2022, No.
					 34).
Note: Authority cited: Section
						127010,
						Health and Safety Code; and Section
						1339.87,
						Health and Safety Code. Reference: Section
						1339.87,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 8 - Hospital Community Reports › Article 1 - 1. Hospital Supplier Diversity Reporting › Section 95009 - Filing an Appeal

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A
				  hospital that has received notice of an accrued penalty under Section
				  95008 may appeal the penalty
				  assessment by filing, as explained in Section
				  95010, a written request for
				  hearing no later than 30 days from the date of the notice. The request shall be
				  filed with the Department's hearing officer.
(b) The request for hearing shall include the
				  following:
(1) The name of the
				  hospital.
(2) The name of the
				  authorized representative of the hospital and contact information for that
				  representative.
(3) The date of the
				  penalty assessment notice.
(4) A
				  statement of the basis for the appeal.
(5) A copy of the penalty
				  notice.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 8 - Hospital Community Reports › Article 1 - 1. Hospital Supplier Diversity Reporting › Section 95010 - Hearing Officer Contact Information

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Hearing requests and other
				  communications, including requests for consolidation, questions about the
				  hearing schedule or process, and all documents and proposed exhibits, shall be
				  addressed to the hearing officer either by mail or by email as follows:
(1) Mail shall be sent to the hearing officer
				  at the Legal Office of the Department of Health Care Access and Information in
				  Sacramento.
(2) Email shall be sent
				  to the following email address: HearingOfficer@hcai.ca.gov.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 8 - Hospital Community Reports › Article 1 - 1. Hospital Supplier Diversity Reporting › Section 95011 - Prehearing Provisions

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  The hospital and the Department will be notified of the hearing date and time
				  at least 30
calendar
days in advance.
(b) The hospital and the Department shall
				  provide copies of all proposed exhibits to the hearing officer and to the other
				  party no later than 10 calendar days prior to the hearing date.
(c) Request to Change Hearing Date. Either
				  party may request a change of hearing date, if necessary. Requests for
				  rescheduling must be submitted to the hearing officer at least 10 business days
				  before the scheduled hearing. Requests for rescheduling must be based upon good
				  cause, as determined by the hearing officer, and will only be granted if the
				  change would not prejudice the other party.
(d) Request to Change Hearing Method. All
				  hearings will be held in Sacramento at the business location of the Department;
				  however, the hearing officer may schedule a hearing to be conducted by
				  telephone or other electronic means. If so, either party may object; upon
				  receipt of such an objection, the hearing officer will schedule an in-person
				  hearing in Sacramento. If the hearing officer does not initially plan to
				  conduct a hearing by telephone or other electronic means, either party may so
				  request; if the hospital and the Office consent, the hearing officer may, but
				  is not required to, conduct the hearing by telephone or other electronic means.
				  The hospital and the Department will be notified of the hearing officer's
				  decision.
(e) Request for
				  Consolidation. The hearing officer may, on their own determination or upon
				  written request of one of the parties, consolidate for hearing or decision any
				  number of appeals when the facts and circumstances are similar and no
				  substantial right of any party will be prejudiced. The hearing officer shall
				  notify both the hospital and the Department if consolidation is occurring.
				  Within five days of receiving the notice of hearing, either party may request
				  consolidation by filing a request with the hearing officer containing the
				  following information:
(1) Identification of
				  the appeals to be consolidated.
(2)
				  A statement of the basis for consolidation.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 8 - Hospital Community Reports › Article 1 - 1. Hospital Supplier Diversity Reporting › Section 95012 - Conduct of Hearing

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The
				  hearing shall be conducted by an employee of the Department appointed by the
				  Director of the Department to serve as hearing officer.
(b) The hearing shall be conducted in person
				  in Sacramento or by telephone or other electronic means as determined by the
				  hearing officer, as specified in Section
				  95011.
(c) The hearing shall not be conducted
				  according to technical rules relating to evidence and witnesses. Any relevant
				  evidence shall be admitted if it is the sort of evidence on which responsible
				  persons are accustomed to rely in the conduct of serious affairs.
(d) All testimony at the hearing shall be
				  taken under oath or affirmation.
(e) The hearing shall be recorded by
				  electronic means unless one party has chosen to provide a court reporter at
				  their own expense as specified in Section
				  95011. A court reporter shall
				  provide the original of the transcript directly to the hearing
				  officer.
(f) The hearing shall be
				  open to the public.
1. New
					 section filed 8-22-2022; operative 10-1-2022 (Register 2022, No.
					 34).
Note: Authority cited: Section
						127010,
						Health and Safety Code; and Section
						1339.87,
						Health and Safety Code. Reference: Section
						1339.87,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 8 - Hospital Community Reports › Article 1 - 1. Hospital Supplier Diversity Reporting › Section 95013 - Settlement

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
If a settlement is reached between the parties prior to the
					 hearing, the Department shall notify the hearing officer and no hearing shall
					 be held.
1. New
					 section filed 8-22-2022; operative 10-1-2022 (Register 2022, No.
					 34).
Note: Authority cited: Section
						127010,
						Health and Safety Code; and Section
						1339.87,
						Health and Safety Code. Reference: Section
						1339.87,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 8 - Hospital Community Reports › Article 1 - 1. Hospital Supplier Diversity Reporting › Section 95014 - Decision

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The hearing
				  officer shall prepare a recommended decision for the Director of the
				  Department; the recommended decision shall be in writing and shall include
				  findings of fact and conclusions of law.
(b) The Director of the Department may either
				  adopt or reject the proposed decision. If the Director does not adopt the
				  proposed decision as presented, they will independently prepare a decision
				  based upon the hearing record; the Director may adopt factual findings of the
				  hearing officer.
1. New
					 section filed 8-22-2022; operative 10-1-2022 (Register 2022, No.
					 34).
Note: Authority cited: Section
						127010,
						Health and Safety Code; and Section
						1339.87,
						Health and Safety Code. Reference: Section
						1339.87,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9 - Hospital Charges and Fair Pricing Policies Reporting › Article 1 - Hospital Charge Description Master Reporting › Section 96000 - Definitions

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
For the purposes of this article, the following definitions
					 from California Health and Safety Code Section
					 1339.51
					 apply:
(a) "Charge description master"
				  means a uniform schedule of charges represented by the hospital as its gross
				  billed charge for a given service or item, regardless of payer type.
(b) "Hospital" means a hospital, as defined
				  in subdivision (a), (b), or (f) of California Health and Safety Code Section
				  1250,
				  that uses a charge description master.
(c) "Office" means the Office of Statewide
				  Health Planning and Development.
1. Amendment
					 of chapter 9 heading, repeal of article 1 heading and new section filed
					 3-23-2005; operative 4-22-2005 (Register 2005, No. 12). For prior history of
					 chapter 9 (articles 1-3, sections
					 96000-96150), see Register 96, No.
					 17.
2. Repealer and new chapter 9 heading and new article 1 heading
					 filed 8-8-2007; operative 9-7-2007 (Register 2007, No.
					 32).
Note: Authority cited: Section
						11152,
						Government Code. Reference: Sections
						1339.55
						and
						1339.56,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9 - Hospital Charges and Fair Pricing Policies Reporting › Article 1 - Hospital Charge Description Master Reporting › Section 96005 - Charge Description Master Reporting

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
On July 1, 2005, and annually on July 1 thereafter, each
					 hospital shall file with the Office a copy of the hospital's charge description
					 master as of June 1 of the same calendar year in one of the following
					 electronic file formats: Microsoft Excel (.xls) or Comma Separated Value
					 (.csv). Hardcopy documents are not acceptable.
1. New
					 section filed 3-23-2005; operative 4-22-2005 (Register 2005, No. 12). For prior
					 history, see Register 96, No. 17.
Note: Authority cited: Section
						11152,
						Government Code. Reference: Section
						1339.55,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9 - Hospital Charges and Fair Pricing Policies Reporting › Article 1 - Hospital Charge Description Master Reporting › Section 96010 - List of Common Outpatient Procedures Reporting

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
On July 1, 2006, and annually on July 1 thereafter, each
					 hospital shall file with the Office a list of its average charges for 25 common
					 outpatient procedures as of June 1 of the same calendar year in one of the
					 following electronic file formats: Microsoft Excel (.xls) or Comma Separated
					 Value (.csv). Hardcopy documents are not acceptable.
1. New
					 section filed 3-23-2005; operative 4-22-2005 (Register 2005, No.
					 12).
2. Amendment of section heading and section filed 5-8-2006;
					 operative 5-8-2006 pursuant to Government Code section
					 11343.4
					 (Register 2006, No. 19).
Note: Authority cited: Section
						11152,
						Government Code. Reference: Section
						1339.56,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9 - Hospital Charges and Fair Pricing Policies Reporting › Article 1 - Hospital Charge Description Master Reporting › Section 96015 - Estimate of Revenue Increase Reporting

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
On July 1, 2006, and annually on July 1 thereafter, each
					 hospital shall file with the Office an estimate of the percentage increase in
					 the hospital's gross revenue due to any price increase for charges for patient
					 services during the 12-month period beginning with the effective date of the
					 previous charge description master filed with the Office. The estimate shall
					 include the estimate calculation and supporting documentation in one of the
					 following electronic file formats: Microsoft Excel (.xls) or Comma Separated
					 Value (.csv). Hardcopy documents are not acceptable.
1. New
					 section filed 3-23-2005; operative 4-22-2005 (Register 2005, No.
					 12).
Note: Authority cited: Section
						11152,
						Government Code. Reference: Section
						1339.55,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9 - Hospital Charges and Fair Pricing Policies Reporting › Article 1 - Hospital Charge Description Master Reporting › Section 96020 - Methods of Submission

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Each hospital shall submit the documents required by
					 Sections 96005,
					 96010, and
					 96015 together as attachments to
					 one e-mail to the Office at
chargemaster@oshpd.ca.gov
.
					 Alternatively, each hospital may submit the electronic files required by
					 Sections 96005,
					 96010, and
					 96015 together on one Compact Disc
					 (CD) by mail to:
OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT,
ACCOUNTING AND REPORTING SYSTEMS SECTION,
818 K STREET, ROOM 400,
SACRAMENTO, CA, 95814.
Hardcopy documents are not acceptable.
1. New
					 section filed 3-23-2005; operative 4-22-2005 (Register 2005, No.
					 12).
Note: Authority cited: Section
						11152,
						Government Code. Reference: Sections
						1339.55
						and
						1339.56,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9 - Hospital Charges and Fair Pricing Policies Reporting › Article 1 - Hospital Charge Description Master Reporting › Section 96025 - Request for Modifications to Requirements

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
To obtain modifications to the requirements specified for
					 electronic file formats, effective date of the documents, submission date of
					 the documents, or methods of submitting electronic files, hospitals shall file
					 written requests for modification with the Office. Hospitals shall have an
					 Office-approved modification prior to implementation of any change to the
					 applicable requirements. Modification requests shall specify the precise
					 changes being requested and the reason(s) the changes are needed. The Office
					 shall either approve or disapprove requests for modification on a case-by-case
					 basis.
1. New
					 section filed 3-23-2005; operative 4-22-2005 (Register 2005, No.
					 12).
Note: Authority cited: Section
						11152,
						Government Code. Reference: Sections
						1339.55
						and
						1339.56,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9 - Hospital Charges and Fair Pricing Policies Reporting › Article 2 - Hospital Fair Pricing Policies Reporting › Section 96040

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Note: Authority cited: Section
						11152,
						Government Code; and Section
						127435,
						Health and Safety Code. Reference: Sections
						127400,
						127405
						and
						127435,
						Health and Safety Code.
Note: Authority cited: Section
						11152,
						Government Code; and Section
						127435,
						Health and Safety Code. Reference: Sections
						127400,
						127405
						and
						127435,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9 - Hospital Charges and Fair Pricing Policies Reporting › Article 2 - Hospital Fair Pricing Policies Reporting › Section 96041

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Note: Authority cited: Section
						11152,
						Government Code; and Section
						127435,
						Health and Safety Code. Reference: Sections
						127405
						and
						127435,
						Health and Safety Code.
Note: Authority cited: Section
						11152,
						Government Code; and Section
						127435,
						Health and Safety Code. Reference: Sections
						127405
						and
						127435,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9 - Hospital Charges and Fair Pricing Policies Reporting › Article 2 - Hospital Fair Pricing Policies Reporting › Section 96042

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Note: Authority cited: Section
						11152,
						Government Code; and Section
						127435,
						Health and Safety Code. Reference: Sections
						127405
						and
						127435,
						Health and Safety Code.
Note: Authority cited: Section
						11152,
						Government Code; and Section
						127435,
						Health and Safety Code. Reference: Sections
						127405
						and
						127435,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9 - Hospital Charges and Fair Pricing Policies Reporting › Article 2 - Hospital Fair Pricing Policies Reporting › Section 96043

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Note: Authority cited: Section
						11152,
						Government Code; and Section
						127435,
						Health and Safety Code. Reference: Sections
						127405
						and
						127435,
						Health and Safety Code.
Note: Authority cited: Section
						11152,
						Government Code; and Section
						127435,
						Health and Safety Code. Reference: Sections
						127405
						and
						127435,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9 - Hospital Charges and Fair Pricing Policies Reporting › Article 2 - Hospital Fair Pricing Policies Reporting › Section 96044

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Note: Authority cited: Section
						11152,
						Government Code; and Section
						127435,
						Health and Safety Code. Reference: Sections
						127405
						and
						127435,
						Health and Safety Code.
Note: Authority cited: Section
						11152,
						Government Code; and Section
						127435,
						Health and Safety Code. Reference: Sections
						127405
						and
						127435,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9 - Hospital Charges and Fair Pricing Policies Reporting › Article 2 - Hospital Fair Pricing Policies Reporting › Section 96045

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Note: Authority cited: Section
						11152,
						Government Code; and Section
						127435,
						Health and Safety Code. Reference: Sections
						127405
						and
						127435,
						Health and Safety Code.
Note: Authority cited: Section
						11152,
						Government Code; and Section
						127435,
						Health and Safety Code. Reference: Sections
						127405
						and
						127435,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9 - Hospital Charges and Fair Pricing Policies Reporting › Article 2 - Hospital Fair Pricing Policies Reporting › Section 96046

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Note: Authority cited: Section
						11152,
						Government Code; and Section
						127435,
						Health and Safety Code. Reference: Sections
						127405
						and
						127435,
						Health and Safety Code.
Note: Authority cited: Section
						11152,
						Government Code; and Section
						127435,
						Health and Safety Code. Reference: Sections
						127405
						and
						127435,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9 - Hospital Charges and Fair Pricing Policies Reporting › Article 2 - Hospital Fair Pricing Policies Reporting › Section 96050

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Note: Authority cited: Section
						11152,
						Government Code; and Section
						127435,
						Health and Safety Code. Reference: Sections
						127405
						and
						127435,
						Health and Safety Code.
Note: Authority cited: Section
						11152,
						Government Code; and Section
						127435,
						Health and Safety Code. Reference: Sections
						127405
						and
						127435,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9.2 - Hospital Fair Billing Program › Article 1 - Definitions; Document Accessibility; Eligibility Determination Letters; Hospital Bill Complaint Program Notice; and Hospital Delegation › Section 96051 - Definitions

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
For purposes of this chapter, the following definitions
					 shall apply in addition to those found in Health and Safety Code section
					 127400:
(a) "Act" means Health and Safety Code
				  sections
				  127400
				  through
				  127446,
				  inclusive.
(b) "Charity care" means
				  the following:
(1) Free health services
				  provided without expectation of payment to persons who meet the hospital's
				  criteria for financial assistance and are unable to pay for all or a portion of
				  the services. Charity care does not include bad debt defined as uncollectible
				  charges that the hospital recorded as revenue but wrote off due to a patient's
				  failure to pay; and/or
(2) Reduced
				  cost health services or free health services provided to eligible patients, as
				  outlined in the hospital's charity care policy.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9.2 - Hospital Fair Billing Program › Article 1 - Definitions; Document Accessibility; Eligibility Determination Letters; Hospital Bill Complaint Program Notice; and Hospital Delegation › Section 96051.1 - Document Accessibility

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) All
				  hospital documents provided or made available to a patient under the Act or
				  this chapter shall comply with the following accessibility requirements:
(1) Be designed and presented in a way that
				  is easy to read and understand by a patient.
(2) Use a sans serif font in at least a
				  12-point size, with section headings in a larger font size or bold/underlined
				  font style to distinguish different sections of the document.
(3) Use plain, straightforward language that
				  avoids technical jargon.
(4) Meet
				  the language requirements outlined in Health and Safety Code section
				  127410(a).
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9.2 - Hospital Fair Billing Program › Article 1 - Definitions; Document Accessibility; Eligibility Determination Letters; Hospital Bill Complaint Program Notice; and Hospital Delegation › Section 96051.2 - Eligibility Determination Letters

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Upon determination of a patient's eligibility for the discount payment program
				  and/or charity care program, a hospital shall issue a letter to the patient,
				  which includes all the following information:
(1) A clear statement of the hospital's
				  determination of the patient's eligibility for the discount payment program
				  and/or charity care program.
(2) If
				  the patient was denied eligibility for discount payment and/or charity care, a
				  clear statement explaining why the patient was denied discount payment, charity
				  care, or both.
(3) If the patient
				  was approved for discount payment or charity care, a clear explanation of the
				  reduced bill and instructions on how the patient may obtain additional
				  information regarding a reasonable payment plan, if applicable.
(4) Name of the hospital office, contact
				  name, and contact information where the patient may appeal the hospital's
				  decision.
(5) Information on the
				  Hospital Bill Complaint Program, as outlined in section
				  96051.3.
(6) Information on Health Consumer Alliance,
				  including the following statement:
Help Paying Your Bill
There are free consumer advocacy organizations that will
					 help you understand the billing and payment process. You may call the Health
					 Consumer Alliance at 888-804-3536 or go to healthconsumer.org for more
					 information.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9.2 - Hospital Fair Billing Program › Article 1 - Definitions; Document Accessibility; Eligibility Determination Letters; Hospital Bill Complaint Program Notice; and Hospital Delegation › Section 96051.3 - Hospital Bill Complaint Program Notice

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
All notices provided to a patient under the Act and this
					 chapter, and all billing statements, shall include the following
					 statement:
Hospital Bill Complaint Program
The Hospital Bill Complaint Program is a state program,
					 which reviews hospital decisions about whether you qualify for help paying your
					 hospital bill. If you believe you were wrongly denied financial assistance, you
					 may file a complaint with the Hospital Bill Complaint Program. Go to
					 HospitalBillComplaintProgram.hcai.ca.gov for more information and to file a
					 complaint.
Note: Authority cited: Section
						127010,
						Health and Safety Code. Reference: Sections
						127405
						and
						127410,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9.2 - Hospital Fair Billing Program › Article 1 - Definitions; Document Accessibility; Eligibility Determination Letters; Hospital Bill Complaint Program Notice; and Hospital Delegation › Section 96051.4 - Hospital Delegation

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Hospital delegation of any of its obligations under the Act
					 and this chapter does not waive the hospital's requirements to comply with the
					 Act and this chapter.
Note: Authority cited: Section
						127010,
						Health and Safety Code. Reference: Section
						127436,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9.2 - Hospital Fair Billing Program › Article 2 - Discount Payment, Charity Care, and Debt Collection Policies and Procedures › Section 96051.5 - Hospital Contact and Registration for Policy Submission

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Each hospital shall designate a primary contact for the purpose of receiving
				  compliance and informational communications regarding the hospital's policies.
				  Each hospital shall also designate a secondary contact that the Department may
				  communicate with in the case that the primary contact is not responsive to the
				  Department.
(b) The primary and
				  secondary contacts shall each register on the Department's online policy
				  submission portal at hdc.hcai.ca.gov by providing the following information:
(1) The legal name of the hospital.
(2) The name of the contact person.
(3) The business title of the contact
				  person.
(4) A business
				  address.
(5) A business
				  email.
(6) A business phone
				  number.
(7) Whether they are the
				  primary or secondary contact.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9.2 - Hospital Fair Billing Program › Article 2 - Discount Payment, Charity Care, and Debt Collection Policies and Procedures › Section 96051.6 - Hospital Policies

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Substantive Policy Requirements.
(1) Each
				  policy submitted shall list an effective date on the policy that reflects the
				  date the policy will go into effect at the hospital.
(2) Discount payment policies and charity
				  care policies shall include eligibility procedures and the hospital's review
				  processes, in accordance with the requirements outlined in the Act.
(3) Each debt collection policy shall include
				  the requirements outlined in Health and Safety Code sections
				  127405(e)(3),
				  127425,
				  127426,
				  and
				  127430,
				  in addition to all other applicable statutory and regulatory
				  requirements.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9.2 - Hospital Fair Billing Program › Article 2 - Discount Payment, Charity Care, and Debt Collection Policies and Procedures › Section 96051.7 - Discount Payment Program

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) All
				  medically necessary services are eligible for the discount payment program.
				  Services performed within the hospital are presumed to be medically necessary
				  unless the hospital provides an attestation that the hospital services at issue
				  in the complaint were not medically necessary. An attestation is considered
				  valid if it is signed by the provider who referred the patient for the hospital
				  services at issue in the complaint or the supervising health care provider for
				  the hospital services at issue in the complaint. The hospital shall obtain the
				  required attestation before it may deny a patient eligibility for the discount
				  payment program on the basis that the services at issue were not medically
				  necessary.
(1) For the purposes of this
				  section, "supervising health care provider" means the primary physician or, if
				  there is no primary physician in the patient's record, the health care provider
				  who had primary responsibility for a patient's health care.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9.2 - Hospital Fair Billing Program › Article 2 - Discount Payment, Charity Care, and Debt Collection Policies and Procedures › Section 96051.8 - Applications for Eligibility for Discount Payment Program or Charity Care Program

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  When a hospital uses a single application form to determine eligibility for
				  both discount payment and charity care programs, the hospital shall make clear
				  on the application form that:
(1) For
				  patients applying only for discount payment program eligibility, the hospital
				  may only request recent paystubs or income tax returns for documentation of
				  income. The hospital may accept other forms of documentation of income but
				  shall not require such other forms.
(2) Patients that only apply for discount
				  payment program eligibility may receive less financial assistance than what may
				  be available to them under the charity care program.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9.2 - Hospital Fair Billing Program › Article 3 - Notice and Posting Requirements › Section 96051.9 - Discharge Notice

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Written notices provided in accordance with Health and Safety Code section
				  127410(a) and
				  (b) shall comply with the following
				  requirements:
(1) Be provided to patients in
				  hardcopy format.
(2) Meet general
				  accessibility standards, pursuant to section
				  96051.1.
(3) Include the following content:
(A) Information on the availability of
				  discount payment and charity care programs and how to apply.
(B) Information on where the patient may
				  access the hospital's discount payment and charity care policies.
(C) Eligibility information.
(D) Contact information for a hospital
				  employee or office where the patient may obtain more information.
(E) Internet website for the hospital's list
				  of shoppable services.
(F)
				  Statement on the Hospital Bill Complaint Program, pursuant to section
				  96051.3.
(G) Information on Health Consumer Alliance,
				  including the following statement:
Help Paying Your Bill
There are free consumer advocacy organizations that will
					 help you understand the billing and payment process. You may call the Health
					 Consumer Alliance at 888-804-3536 or go to healthconsumer.org for more
					 information.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9.2 - Hospital Fair Billing Program › Article 3 - Notice and Posting Requirements › Section 96051.10 - Hospital Postings

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Hospital postings in accordance with Health and Safety Code section
				  127410(c)
				  shall comply with the following requirements:
(1) Use a sans serif font.
(2) Use a white background and black
				  text.
(3) Use paper that is no
				  smaller than an 11? x 17? sheet.
(4) Be designed and presented in a way that
				  is easy to read and understand by the patient.
(5) Use plain, straightforward language that
				  avoids technical jargon.
(6) Meet
				  the language requirements outlined in Health and Safety Code section
				  127410(a).
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9.2 - Hospital Fair Billing Program › Article 3 - Notice and Posting Requirements › Section 96051.11 - Website Requirements

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Notice requirements on the hospital's internet website pursuant to Health and
				  Safety Code section
				  127410(c)(5)
				  shall comply with the following requirements:
(1) Hospitals shall maintain an internet
				  webpage titled "Help Paying Your Bill," including, but not limited to, the
				  following information on discount payment and charity care:
(A) Eligibility requirements.
(B) Instructions on how to apply.
(C) Link to the discount payment and charity
				  care policies and application(s).
(D) Office where the patient may go for more
				  information.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9.2 - Hospital Fair Billing Program › Article 4 - Hospital Bill Complaint Program › Section 96051.12 - Hospital Designated Contact and Statement of Certification

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Each hospital shall identify a primary contact who shall register with the
				  Department's online patient complaint portal to review and respond to patient
				  complaints.
(b) The primary contact
				  shall provide the following information:
(1)
				  The legal name of the hospital.
(2)
				  The name of the primary contact designated to receive communications from the
				  Department.
(3) The business title
				  of the primary contact.
(4) A
				  business address.
(5) A business
				  email address.
(6) A business phone
				  number.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9.2 - Hospital Fair Billing Program › Article 4 - Hospital Bill Complaint Program › Section 96051.13 - Patient Complaint Portal

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The patient or patient's authorized representative may file
					 a complaint through the Department's Hospital Bill Complaint Program online
					 patient complaint portal by visiting the Department's website at
					 HospitalBillComplaintProgram.hcai.ca.gov, or by mail to the Department of
					 Health Care Access and Information, Hospital Bill Complaint Program, located at
					 2020 West El Camino Avenue, Suite 1101, Sacramento, CA 95833.
Note: Authority cited: Section
						127010,
						Health and Safety Code. Reference: Section
						127436,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9.2 - Hospital Fair Billing Program › Article 4 - Hospital Bill Complaint Program › Section 96051.14 - Authorized Representative

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) For
				  purposes of this chapter, "authorized representative" means any of the
				  following:
(1) Any individual appointed in
				  writing by the patient to act on behalf of the patient.
(2) Any individual designated by law to act
				  on behalf of the patient. The individual must provide documentation of legal
				  authority to act as the patient's authorized representative.
(3) The parent, guardian, or conservator of a
				  minor patient.
California Code of Regulations › Title 22 - Social Security › Division 7 - Health Planning and Facility Construction › Chapter 9.2 - Hospital Fair Billing Program › Article 4 - Hospital Bill Complaint Program › Section 96051.15 - Release of Information

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The patient shall sign a release of information authorizing
					 the hospital and the patient's providers, past and present, to release the
					 patient's information related to the complaint to the Department. These records
					 may include financial information, billing, medical, mental health, substance
					 abuse, HIV, diagnostic imaging reports, and other records related to the
					 complaint. A signed release of information is required for each complaint and
					 will be valid until the investigation is closed or the release is revoked by
					 the patient.
Note: Authority cited: Section
						127010,
						Health and Safety Code. Reference: Section
						127436,
						Health and Safety Code.