California Code of Regulations › Title 2 - Administration › Division 2 - Financial Operations › Chapter 1 - California Victim Compensation Board (Calvcb) Regulations › Article 5.6 - Indemnification of Victims of Crime › Section 649.26 - Direct Payment to Providers

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  If the VCP authorizes direct payment to a healthcare provider of VCP services,
				  the VCP may require the provider to submit bills using CMS 1450, CMS 1500 or
				  American Dental Association bill forms for verification of services provided.
				  Applicants are not required to use the above-noted forms to request
				  reimbursement of eligible pecuniary losses that they paid.
(b) The VCP shall inform the victim or
				  derivative victim of his or her right to object to direct payments by VCP to
				  providers of services in accordance with Government Code section
				  13957.7(c)(1).
				  In the event that the victim or derivative victim asserts such right the VCP
				  may reimburse pecuniary loss to the victim or derivative victim only in amounts
				  equal to sums actually paid out by the victim or derivative victim to the
				  service provider and only upon submission by the victim, the victim's
				  survivors, or derivative victim of evidence of such payments, subject to the
				  rates and limitations set by the Board in accordance with applicable law.
				  Following such an objection, direct payment shall be made to the provider only
				  upon a demonstration of good cause as determined by the board.
(c) For consideration of payment for mental
				  health counseling over the claimant's authorized session limit, mental health
				  providers must submit the VCP Treatment Plan and the VCP Additional Treatment
				  Plan for review and approval within 90 days of the date VCP receives the bill
				  for sessions that exhaust the claimant's authorized session limit. If the VCP
				  Treatment Plan and VCP Additional Treatment Plan are not submitted within the
				  90 day timeframe, bills for all dates of service that exceed the authorized
				  session limit will be returned and will not be considered for payment. However,
				  bills for dates of service provided after the VCP Treatment Plan and VCP
				  Additional Treatment Plan are received may be considered if the VCP Additional
				  Treatment Plan is approved and the authorized session limit is
				  increased.
1. Change
					 without regulatory effect renumbering former section
					 649.18 to section
					 649.26, including amendment of
					 section and NOTE, filed 12-6-2007 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 2007, No. 49). For prior history of section
					 649.26, see Register 2006, No.
					 4.
2. Amendment filed 6-12-2009; operative 7-12-2009 (Register 2009,
					 No. 24).
3. Amendment of section heading and section filed 1-6-2011;
					 operative 2-5-2011 (Register 2011, No. 1).
4. New subsection (c)
					 filed 8-12-2014; operative 10-1-2014 (Register 2014, No.
					 33).
Note: Authority cited: Section
						13974,
						Government Code, Reference: Section
						13957.7,
						Government Code.