reglab/statecodes huggingface dataset:
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51142 - Inpatient Services

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Inpatient services" means preventive diagnostic, or
						treatment services provided in a hospital, skilled nursing facility, or
						intermediate care facility to a patient who is a registered inpatient in that
						facility.
1. New
						section filed 9-27-72; designated effective 11-1-72 (Register 72, No.
						40).
2. Amendment filed 8-8-78; effective thirtieth day thereafer
						(Register 78, No. 32).
3. Change without regulatory effect adding
						NOTE (Register 86, No. 49).
Note: Authority cited: Sections
						  10725,
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51143 - Outpatient Services

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Outpatient services" means preventive, diagnostic, or
						treatment services other than inpatient services.
1.
						Amendment filed 9-27-72; designated effective 11-1-72 (Register 72, No. 40).
						For prior history, see Register 72, No. 31.
2. Change without
						regulatory effect adding NOTE (Register 86, No.
						49).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51145 - Home

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
For the purposes of providing home health agency
						services, home means any place of residence of a beneficiary, other than while
						a registered inpatient of a hospital or skilled nursing facility or
						intermediate care facility.
1.
						Amendment filed 9-30-71 as an emergency; designated effective 10-1-71 (Register
						71, No. 40).
2. Certificate of Compliance--Section
						11422.1,
						Gov. Code, filed 1-25-72 (Register 72, No. 5).
3. Amendment filed
						8-8-78; effective thirtieth day thereafter (Register 78, No. 32).
4.
						Change without regulatory effect adding NOTE (Register 86, No.
						49).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51145.1 - "Home" Defined for the Personal Care Services Program

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
For purposes of Section
						51350(b), "home"
						means that place in which the beneficiary chooses to reside. A person receiving
						an SSI/SSP payment for a nonmedical out-of-home living arrangement is not
						considered to be living in his/her "home". The beneficiary's "home" does not
						include a board and care facility, a facility licensed by the California State
						Department of Health Services nor a community care facility or a residential
						care facility licensed by the California State Department of Social
						Services.
1. New
						section filed 4-14-93 as an emergency; operative 4-14-93. Submitted to OAL for
						printing only pursuant to section
						8, AB 1773 (Chapter 939, Statutes
						of 1992) (Register 93, No. 16).
Note: Authority cited: Section
						  14132.95,
						  Welfare and Institutions Code; Section
						  8, Chapter 939, Statutes of 1922;
						  Section 3, Chapter 7, Statutes of 1993.
						  Reference: Section
						  14132.95,
						  Welfare and Institutions Code; Section
						  1396 d(a)(7) of Title 42, of the
						  United States Code; Article 7 (commencing with Section
						  12300) of Part 3 of Division 9 of
						  the Welfare and Institutions Code; Section
						  440.170(f) of
						  Title 42 of the Code of Federal
						  Regulations.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51146 - Homebound Patient

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
A homebound patient is defined as one who is essentially
						confined to his home due to illness or injury, and if ambulatory or otherwise
						mobile, is unable to be absent from his home except on an infrequent basis or
						for periods of relatively short duration; e.g. for a short walk prescribed as
						therapeutic exercise.
1. New
						section filed 7-1-70; designated effective 8-1-70 (Register 70, No.
						27).
2. Change without regulatory effect adding NOTE (Register 86,
						No. 49).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51147 - Medical Social Work or Medical Social Services

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Medical Social Work or Medical Social Services, as
						referred to in Section
						51125 and
						51129 means professional services,
						provided by a person with a master's degree from a recognized school of social
						work, to assist individuals and groups in their efforts to solve medical-social
						problems that arise as a result of their illness or
						disabilities.
1.
						Amendment filed 6-5-67 as an emergency; effective upon filing. Certificate of
						Compliance filed 6-9-67 (Register 67, No. 23).
2. Amendment filed
						9-30-71 as an emergency; designated effective 10-1-71 (Register 71, No.
						40).
3. Certificate of Compliance--Section
						11422.1,
						Gov. Code, filed 1-25-72 (Register 72, No. 5).
4. Change without
						regulatory effect adding NOTE (Register 86, No.
						49).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51149 - Social Work Services. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. Refiled
						6-5-67 as an emergency; effective upon filing. Certificate of Compliance filed
						6-9-67 (Register 67, No. 23).
2. Repealer filed 9-30-71 as an
						emergency; designated effective 10-1-71 (Register 71, No. 40).
3.
						Certificate of Compliance--Section
						11422.1,
						Gov. Code, filed 1-25-72 (Register 72, No.
						5).
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51151 - Medical Transportation Services

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Medical transportation services" means the
						transportation of the sick, injured, invalid, convalescent, infirm or otherwise
						incapacitated persons by ambulances, litter vans or wheelchair vans licensed,
						operated, and equipped in accordance with applicable state or local statutes,
						ordinances or regulations. Medical transportation services do not include
						transportation of beneficiaries by passenger car, taxicabs or other forms of
						public or private conveyances.
1. New
						section filed 6-23-66 as an emergency; effective upon filing; Certificate of
						Compliance included (Register 66, No. 19).
2. Amendment filed
						2-25-70; designated effective 4-1-70 (Register 70, No. 9).
3.
						Amendment filed 5-22-80; effective thirtieth day thereafter (Register 80, No.
						21).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51151.1 - Ambulance

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Ambulance" means a vehicle specially constructed,
						modified, equipped and used for the purpose of transporting sick, injured,
						invalid, convalescent, infirm or otherwise incapacitated
						persons.
1. New
						section filed 5-22-80; effective thirtieth day thereafter (Register 80, No.
						21).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51151.2 - Ambulance Patient

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Ambulance patient" means a patient whose medical
						condition requires the specialized services, equipment and personnel available
						in an ambulance.
1. New
						section filed 5-22-80; effective thirtieth day thereafter (Register 80, No.
						21).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51151.3 - Litter Van

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Litter van" means a vehicle which is modified, equipped
						and used for the purpose of providing nonemergency medical transportation for
						those patients with stable medical conditions who require the use of a litter
						or gurney and which is not routinely equipped with the medical equipment or
						personnel required for the specialized care provided in an
						ambulance.
1. New
						section filed 5-22-80; effective thirtieth day thereafter (Register 80, No.
						21).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51151.4 - Litter Van Patient

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Litter van patient" means a patient whose medical
						condition is such that the patient may be transported by a litter
						van.
1. New
						section filed 5-22-80; effective thirtieth day thereafter (Register 80, No.
						21).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51151.5 - Wheelchair Van

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Wheelchair van" means a vehicle which is modified,
						equipped and used for the purpose of providing nonemergency medical
						transportation for wheelchair van patients and which is not routinely equipped
						with the medical equipment or personnel required for the specialized care
						provided in an ambulance.
1. New
						section filed 5-22-80; effective thirtieth day thereafter (Register 80, No.
						21).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51151.6 - Wheelchair Van Patient. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New
						section filed 5-22-80; effective thirtieth day thereafter (Register 80, No.
						21).
2. Repealer filed 6-22-87; operative 7-22-87 (Register 87, No.
						27).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51151.7 - Nonemergency Medical Transportation

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Nonemergency medical transportation" means
						transportation by ambulance, litter van and wheelchair van of the sick,
						injured, invalid, convalescent, infirm or otherwise incapacitated persons whose
						medical conditions require medical transportation services but do not require
						emergency services or equipment during transport.
1. New
						section filed 5-22-80; effective thirtieth day thereafter (Register 80, No.
						21).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51152 - Provider of Medical Transportation

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Provider of medical transportation" means an individual
						or organization furnishing medical transportation services as defined in
						Section 51151.
1. New
						section filed 1-30-73; effective thirtieth day thereafter (Register 73, No.
						5).
2. Change without regulatory effect adding NOTE (Register 86,
						No. 49).
Note: Authority cited: Sections
						  10725,
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51153 - Other Medically Indicated Transportation Service. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New
						section filed 6-23-66 as an emergency; effective upon filing; Certificate of
						Compliance included (Register 66, No. 19).
2. Repealer filed
						2-25-70; designated effective 4-1-70 (Register 70, No.
						9).
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51154 - Renal Dialysis Center

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Renal dialysis center" means a facility which provides
						chronic hemodialysis and evaluates and treats renal disease.
1. New
						section filed 9-27-72; designated effective 11-1-72 (Register 72, No.
						40).
2. Change without regulatory effect adding NOTE (Register 86,
						No. 49).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51155 - Community Hemodialysis Unit

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Community hemodialysis unit" means a facility which
						provides chronic hemodialysis and supervision of patients undergoing chronic
						home hemodialysis.
1. New
						section filed 9-27-72; designated effective 11-1-72 (Register 72, No.
						40).
2. Change without regulatory effect adding NOTE (Register 86,
						No. 49).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51156 - Renal Homotransplantation Center

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Renal homotransplantation center" means a hospital at
						which renal homotransplantation is performed and which provides or has
						available the supportive personnel and services required to perform renal
						homotransplantation.
1. New
						section filed 9-27-72; designated effective 11-1-72 (Register 72, No.
						40).
2. Change without regulatory effect adding NOTE (Register 86,
						No. 49).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51157 - Renal Dialysis, Renal Homotransplantation and Related Services

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) "Renal dialysis" means removal by
					 artificial means of waste products normally excreted by the kidneys. Such
					 removal may be accomplished by the use of an artificial kidney or peritoneal
					 dialysis on a continuing basis.
(b)
					 "Renal homotransplantation" means the implantation of a kidney from one person
					 to another for the treatment of renal disease.
(c) "Related services" means hospital
					 inpatient and physician's services related to the treatment of renal failure,
					 stabilization of renal failure, treatment of complications of dialysis, and
					 dialysis related laboratory tests, medical supplies, and drugs.
1. New
						section filed 4-25-75 as an emergency, effective upon filing (Register 75, No.
						17).
2. Certificate of Compliance filed 8-7-75 (Register 75, No.
						32).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14140-
						  14144,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51158 - Nurse Anesthetist

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Nurse Anesthetist means a registered nurse who has
						completed a course of training in a School of Anesthesia accredited by the
						American Association of Nurse Anesthetists.
1. New
						section filed 5-1-75 as an emergency; effective upon filing (Register 75, No.
						18).
2. Certificate of Compliance filed 8-19-75 (Register 75, No.
						34).
3. Repealer filed 2-5-88; operative 3-6-88 (Register 88, No.
						8).
Note: Authority cited: Sections
						  14105,
						  14115.3
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14115.3,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51159 - Utilization Controls

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Utilization controls that may be applied to services set
						forth in this chapter include:
(a)
					 Prior authorization, which is approval in advance of the rendering of service
					 of the medical necessity and program coverage of the requested services, by a
					 Department of Health consultant or PCCM plan.
In determining what services shall be subject to prior
						authorization, the Director shall consider factors which include, but are not
						limited to:
(1) Whether the services
					 to be controlled are generally considered to be elective procedures.
(2) Whether other physician procedures not
					 subject to prior authorization are sufficient in scope and number to afford
					 beneficiaries reasonable access to necessary health care services.
(3) The level of program payment for
					 procedures.
(4) The cost
					 effectiveness of applying prior authorization as a utilization
					 control.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51159.1 - Peer Review

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The Department may request peer review of provider claims
						or practices by medical, pharmaceutical or other professional associations or
						societies. The recommendations of the peer review body to the Department shall
						be advisory but shall be carefully considered by the
						Department.
1. New
						section filed 11-28-75; designated effective 1-1-76 (Register 75, No.
						48).
2. Repealer and new section filed 5-15-81; effective thirtieth
						day thereafter (Register 81, No. 20).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14132
						  and
						  14133,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51160 - Durable Medical Equipment

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Durable medical equipment means equipment prescribed by a
						licensed practitioner to meet medical equipment needs of the patient
						that:
(a) Can withstand repeated
					 use.
(b) Is used to serve a medical
					 purpose.
(c) Is not useful to an
					 individual in the absence of an illness, injury, functional impairment, or
					 congenital anomaly.
(d) Is
					 appropriate for use in or out of the patient's home.
1. New
						section filed 5-14-76 as an emergency; effective upon filing (Register 76, No.
						20).
2. Certificate of Compliance filed 9-8-76 (Register 76, No.
						37).
3. Change without regulatory effect of NOTE (Register 86, No.
						49).
4. Amendment of first paragraph and new subsections (a)-(d)
						filed 6-5-2000 as an emergency; operative 6-5-2000 (Register 2000, No. 23). A
						Certificate of Compliance must be transmitted to OAL by 10-3-2000 or emergency
						language will be repealed by operation of law on the following
						day.
5. Amendment of first paragraph and new subsections (a)-(d)
						refiled 8-21-2000 as an emergency; operative 10-3-2000 (Register 2000, No. 34).
						A Certificate of Compliance must be transmitted to OAL by 1-31-2001 or
						emergency language will be repealed by operation of law on the following
						day.
6. Certificate of Compliance as to 8-21-2000 order, including
						further amendment of subsections (c) and (d), transmitted to OAL 1-3-2001 and
						filed 2-5-2001 (Register 2001, No. 6).
Note: Authority cited: Section
						  14105,
						  Welfare and Institutions Code. Reference: Sections
						  14131
						  and
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51162 - Eyeglasses, Prosthetic Eyes, and Other Eye Appliances

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Eyeglasses, prosthetic eyes and other eye appliances
						means those items prescribed by a physician or optometrist for medical
						conditions related to the eye.
1. New
						section filed 5-14-76 as an emergency; effective upon filing (Register 76, No.
						20).
2. Certificate of Compliance filed 9-8-76 (Register 76, No.
						37).
3. Change without regulatory effect of NOTE (Register 86, No.
						49).
Note: Authority cited: Section
						  14105,
						  Welfare and Institutions Code. Reference: Sections
						  14131
						  and
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51162.1 - Fabricating Optical Laboratory

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Fabricating optical laboratory" means a laboratory which
						surfaces, cuts and edges ophthalmic lenses; fabricates eye appliances as
						specified in Section
						51519.2; and has entered into an
						exclusive area negotiated contract with the Department of Health Services. An
						"exclusive area negotiated contract" means a non-bid contract let under the
						statutory authority of Section
						14105.3
						of the Welfare and Institutions Code which allows the Department to purchase
						ophthalmic appliances for Medi-Cal beneficiaries living in a designated
						geographic area from a specific fabricating optical
						laboratory.
1. New
						section filed 11-28-88 as an emergency; operative 11-28-88 (Register 89, No.
						11). A Certificate of Compliance must be transmitted to OAL within 120 days or
						emergency language will be repealed on 3-28-89.
2. Certificate of
						Compliance as to 11-28-88 order including amendment transmitted to OAL 3-27-89
						and filed 4-26-89 (Register 89, No. 18).
3. Editorial correction of
						text adding "as specified in Section
						51519.2" which was inadvertently
						omitted from Register 89, No. 18 and correction of History No. 2 (Register 89,
						No. 38).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code; and Section
						  87, Chapter 1594, Statutes of
						  1982. Reference: Sections
						  14105.3
						  and
						  14132,
						  Welfare and Institutions Code; Section
						  26685,
						  Health and Safety Code; and Sections
						  2541.3
						  and
						  2541.6,
						  Business and Professions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51163 - Human Reproductive Sterilization

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Human reproductive sterilization means
					 any medical treatment, procedure or operation, for the purpose of rendering an
					 individual permanently incapable of reproducing.
(b) In this section, and in Sections
					 51305.1 through
					 51305.6, "sterilization" means
					 human reproductive sterilization.
1. New
						section filed 5-27-77; effective thirtieth day thereafter (Register 77, No.
						22).
2. Amendment titled 6-24-80; designated effective 10-15-80
						(Register 80, No. 26).
Note: Authority cited: Sections
						  14105,
						  14124.5
						  and
						  14191,
						  Welfare and Institutions Code. Reference: Sections
						  14053,
						  14059,
						  14132
						  and
						  14191,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51164 - Intermediate Care Facility for the Developmentally Disabled

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Intermediate care facility for the developmentally
						disabled means a facility which:
(a)
					 Meets the provisions of Section
					 76079 of Title 22 of the
					 California Administrative Code, and
(b) Has as its primary purposes, the
					 furnishing of health 24-hour developmental, training and habilitative, and
					 supportive health services to persons with a developmental disability as
					 defined in Welfare and Institutions Code Section
					 4512.
1.
						Emergency language filed 3-29-84 repealed by operation of Government Code
						Section
						11346.1(f)
						(Register 85, No. 19).
2. Amendment filed by the Department of
						Health Services with the Secretary of State on 8-1-84 as an emergency;
						effective upon filing. Submitted to OAL for printing only pursuant to
						Government Code Section
						11343.8
						(Register 85, No. 19).
3. Certificate of Compliance including
						amendment filed by the Department of Health Services with the Secretary of
						State on 11-28-84. Submitted to OAL for printing only pursuant to Government
						Code Section
						11343.8
						(Register 85, No. 25).
Note: Authority cited: Section
						  14124.5,
						  Welfare and Institutions Code; and Sections
						  208.4,
						  Health and Safety Code. Reference: Section
						  14132,
						  Welfare and Institutions Code; and Section
						  1250,
						  Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51164.1 - Intermediate Care Facility for the Developmentally Disabled Habilitative

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Intermediate
					 care facility for the developmentally disabled habilitative means a facility
					 which:
(1) Has as its primary purposes, the
					 furnishing of 24-hour personal care, developmental, training and habilitative,
					 and supportive health services in a facility with 15 beds or less to residents
					 with a developmental disability. Developmental disability is a disability which
					 originates before age 18 and is a permanent substantial handicap as defined in
					 Welfare and Institutions Code Section
					 4512.
(2) Provides services to the developmentally
					 disabled in the least restrictive community type setting.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51164.2 - Intermediate Care Facility for the Developmentally Disabled-Nursing

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Intermediate care facility for the developmentally
						disabled-nursing means a facility which:
(a) Has as its primary purpose, the
					 furnishing of 24-hour nursing supervision, personal care, training and
					 habilitative services in a facility with 4-15 beds to medically fragile
					 developmentally disabled beneficiaries, or to beneficiaries who demonstrate a
					 significant developmental delay that may lead to a developmental disability if
					 not treated. Such beneficiaries shall have been certified by a physician as not
					 requiring continuous skilled nursing care. Developmental disability is a
					 disability as defined in Welfare and Institutions Code Section
					 4512.
(b) Provides services to medically fragile
					 developmentally disabled beneficiaries in the least restrictive community
					 setting.
1. New
						section refiled by the Department of Health Services with the Secretary of
						State on 5-30-89 as an emergency pursuant to Health and Safety Code Section
						1275.3;
						operative 5-30-89. Submitted to OAL for printing only pursuant to Government
						Code Section
						11343.8
						(Register 89, No. 23). For prior history, see Register 89, No. 1.
2.
						Certificate of Compliance as to 5-30-89 order including amendment of subsection
						(a) transmitted to OAL 9-27-89 and filed 10-26-89 (Register 89, No.
						44).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code; and Sections
						  208,
						  208.4
						  and
						  1275.3,
						  Health and Safety Code. Reference: Sections
						  1250,
						  1250.1
						  and
						  1275.3,
						  Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51165 - Intermediate Care Facility Services for the Developmentally Disabled

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Intermediate
					 care facility services for the developmentally disabled means those services
					 provided in intermediate care facilities for the developmentally disabled,
					 pursuant to the provisions of Sections
					 76301 through
					 76413 of Title 22 of the
					 California Administrative Code, except as indicated in (b).
(b) Intermediate care facility services for
					 the developmentally disabled except as reimbursed under Section
					 51510.1 do not include:
(1) Services rendered in acordance with
					 Section 51305, Physicians' Services;
					 51306, Optometry Services; 51307, Dental Services; 51308, Chiropractic
					 Services; 51309, Psychology, Physical Therapy, Occupational Therapy, Speech
					 Therapy and Audiological Services; 51310, Podiatry Services; 51311, Laboratory,
					 Radiological and Radioisotope Services; 51312, Prayer or Spiritual Healing;
					 51313, Pharmaceutical Services and Prescribed Drugs; 51314, Rehabilitation
					 Center Outpatient Services; 51315, Prosthetic and Orthotic Appliances; 51317,
					 Eyeglasses, Contact Lenses, Low Vision Aids, Prosthetic Eyes and Other Eye
					 Appliances; 51319, Hearing Aids; 51320, Medical Supplies; 51321, Durable
					 Medical Equipment, except as provided in Section
					 51321(h)(4);
					 51323, Medical Transportation Services; 51325, Blood and Blood Derivatives;
					 51326, Nurse Anesthetist Services; 51327, Inpatient Hospital Services; 51328,
					 Outpatient Detoxification Services; 51330, Chronic Hemodialysis; 51330.1, Renal
					 Homotransplantation; 51331, Hospital Outpatient Department and Organized
					 Outpatient Clinic Services; 51337, Home Health Agency Services; 51340, Early
					 and Periodic Screening Services; and 51341, Short-Doyle/Medi-Cal Provider
					 Services.
(2) Other equipment and
					 supplies for which prior authorizations have been granted to other providers by
					 the Medi-Cal consultant and which are therefore separately billed by other
					 providers of services.
(3) Personal
					 care items and services for which a personal and incidental allowance is
					 provided.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51165.1 - Intermediate Care Facility Services for the Developmentally Disabled Habilitative

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Intermediate care facility services for the
						developmentally disabled habilitative means those services provided pursuant to
						Sections 76853 through
						76906 of Title 22 of the
						California Administrative Code. Included are services of the interdisciplinary
						professional staff/team in providing case conference review of clients'
						developmental needs, developing and implementing programs and providing
						specific training and expertise to the program staff who implement the
						individual service plans.
1. New
						section filed by the Department of Health Services with the Secretary of State
						on 8-1-84 as an emergency; effective upon filing. Submitted to OAL for printing
						only pursuant to Government Code Section
						11343.8
						(Register 85, No. 19).
2. Certificate of Compliance filed by the
						Department of Health Services with the Secretary of State on 11-28-84.
						Submitted to OAL for printing only pursuant to Government Code Section
						11343.8
						(Register 85, No. 25).
Note: Authority cited. Section
						  14124.5,
						  Welfare and Institutions Code; and Sections
						  208.3,
						  208.4
						  and
						  1267.7,
						  Health and Safety Code. Reference: Section
						  14132,
						  Welfare and Institutions Code; and Section
						  1250,
						  Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51165.2 - Intermediate Care Facility Services for the Developmentally Disabled -Nursing

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Intermediate care facility services for the
						developmentally disabled-nursing means those services provided pursuant to
						Sections 73856 through
						73907, Title 22, California Code
						of Regulations.
1. New
						section refiled by the Department of Health Services with the Secretary of
						State on 5-30-89 as an emergency pursuant to Health and Safety Code Section
						1275.3;
						operative 5-30-89. Submitted to OAL for printing only pursuant to Government
						Code Section
						11343.8
						(Register 89, No. 23). For prior history, see Register 89, No. 1.
2.
						Certificate of Compliance as to 5-30-89 order including amendment transmitted
						to OAL 9-27-89 and filed 10-26-89 (Register 89, No.
						44).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code; and Sections
						  208,
						  208.3,
						  208.4,
						  1250.1
						  and
						  1275.3,
						  Health and Safety Code. Reference: Sections
						  1250.1
						  and
						  1275.3,
						  Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51170 - Nonphysician Medical Practitioner

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Nonphysician medical practitioner" means a nurse
						midwife, physician's assistant, or nurse practitioner who provides primary
						care.
1. New
						section filed 8-1-78 as an emergency; effective upon filing (Register 78, No.
						31).
2. Certificate of Compliance filed 8-9-78 (Register 78, No.
						31).
Note: Authority cited: Sections
						  14053,
						  14105,
						  14124.5
						  and
						  14132,
						  Welfare and Institutions Code. Reference: Article 12.5 of Chapter 5, Articles 2
						  and 2.5 of Chapter 6, and Chapter 7.7, Business and Professions
						  Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51170.1 - Physician's Assistant

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 "Physician's assistant" means a person whom the California Board of Medical
					 Quality Assurance has currently:
(1)
					 Certified as a primary health care, women's health care or emergency care
					 physician's assistant.
(2) Approved
					 to perform direct patient care services under the supervision of a primary care
					 physician approved by the Board.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51170.2 - Nurse Midwife

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Nurse midwife" means a person who is licensed as a
						registered nurse and who is currently certified as a nurse midwife by the
						California Board of Registered Nursing.
1. New
						section filed 8-1-78 as an emergency; effective upon filing (Register 78, No.
						31).
2. Certificate of Compliance filed 8-9-78 (Register 78, No.
						31).
3. Change without regulatory effect of NOTE (Register 86, No.
						49).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14059
						  and
						  14132,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51170.3 - Nurse Practitioner

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 "Nurse practitioner" means a licensed registered nurse:
(1) Who is certified by the Board of
					 Registered Nursing as a nurse practitioner.
(2) Whose practice is predominantly that of
					 primary care.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51170.5 - Primary Care

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 "Primary care" means health professional services provided in a continuing
					 relationship established with an individual or family group in order to
					 provide:
(1) Surveillance of health
					 needs.
(2) Access to comprehensive
					 health care.
(3) Referral to other
					 health professionals.
(4) Health
					 counseling and patient education.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51171 - Physician-Practitioner Interface

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Physician-Practitioner Interface" means the system of
						collaboration and physician supervision by which medical treatment services
						provided by physicians and nonphysician medical practitioners are integrated
						and made consistent with accepted medical practice.
1. New
						section filed 8-1-78 as an emergency; effective upon filing (Register 78, No.
						31).
2. Certificate of Compliance filed 8-9-78 (Register 78, No.
						31).
Note: Authority cited: Sections
						  14053,
						  14105,
						  14124.5
						  and
						  14132,
						  Welfare and Institutions Code. Reference: Article 12.5 of Chapter 5, Articles 2
						  and 2.5 of Chapter 6 and Chapter 7.7, Business and Professions
						  Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51172 - Date of Service

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Notwithstanding any other Department regulation, for
						purposes of billing for prescribed drugs, the date of service means the date a
						prescription is filled. If the drug has not been received by the beneficiary or
						the beneficiary's representative within 15 days after the prescription is
						filled, the pharmacy must reverse the claim and refund the payment to the
						Department.
1. New
						section filed 4-9-80; effective thirtieth day thereafter (Register 80, No.
						15).
2. Amendment filed 1-9-95; operative 3-1-95 (Register 95, No.
						2).
Note: Authority cited: Sections
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14124.1
						  and
						  14124.2,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51173 - Acute Administrative Days

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Acute administrative days means those days approved in an
						acute inpatient facility which provides a higher level of medical care than
						that currently needed by the patient.
1. New
						section filed 4-28-82; designated effective 6-1-82 (Register 82, No.
						18).
Note: Authority cited: Section
						  14105(a),
						  Welfare and Institutions Code. Reference: Section
						  14105(a),
						  Welfare and Institutions Code.