§ 56200. Organization and Administration.

Each PCCM plan shall have the organizational and administrative ability to carry out its contractual obligations.To demonstrate this ability, each PCCM plan shall maintain the following:

(a) A license to provide medical care.

(b) An approved Medi-Cal provider number.

(c) A grievance procedure as specified in section 56260.

(d) Member and enrollment reporting systems which fulfill the PCCM plan's contractual obligations.

(e) A data-reporting system which provides reports required under the contract to the Department on a timely basis.

(f) Financial records and books of account fully disclosing the disposition of all Medi-Cal program funds received under the PCCM contract. These records and books shall be maintained on the accrual basis and in a uniform accounting system in accordance with generally accepted accounting principles.

(g) A medical director as specified in section 56246.

HISTORY

1. New section filed 3-9-90 as an emergency; operative 3-9-90 (Register 90, No. 12). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 7-9-90.

2. New section refiled 7-9-90 as an emergency; operative 7-9-90 (Register 90, No. 35). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed by operation of law on 11-6-90.

3. Request to readopt section on an emergency basis pursuant to Government Code section 11346.1 granted and filed 11-6-90 as an emergency; operative 11-6-90 (Register 91, No. 6). A Certificate of Compliance must be transmitted to OAL by 3-6-91 or emergency language will be repealed by operation of law on the following day.

4. Certificate of Compliance as to 11-6-90 order transmitted to OAL 2-22-91; disapproved by OAL on 3-25-91 (Register 91, No. 18).

5. New section filed 3-25-91 as an emergency; operative 3-25-91 (Register 91, No. 18). A Certificate of Compliance must be transmitted to OAL by 7-23-91 or emergency language will be repealed by operation of law on the following day.

6. Certificate of Compliance as to 3-25-91 order including amendment of subsections (d) and (f) transmitted to OAL 7-19-91 and filed 8-19-91 (Register 92, No. 1).

Note

Note: Authority cited: Sections 14105 and 14124.5, Welfare and Institutions Code. Reference: Sections 14088.16 and 14088.2, Welfare and Institutions Code.