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 California Code of Regulations (Last Updated: August 6, 2014)
 Title 22. Social Security
 Division 3. Health Care Services
 Subdivision 1. California Medical Assistance Program
 Chapter 6. Primary Care Case Management Plans
 Article 3. Operational Requirements

  § 56246. Medical Director.  

Latest version.
  • Each PCCM plan shall appoint a physician as medical director. The medical director's responsibilities shall include, but not be limited to:
    (a) Ensuring that medical decisions are rendered by qualified medical personnel.
    (b) Ensuring that authorized physicians and medical personnel are trained on Treatment Authorization Requests, authorization requirements, and procedures for noncapitated services.
    (c) Ensuring that the PCCM plan's medical standards are followed.
    (d) Developing and implementing medical policy.
    (e) Resolving medically related grievances. The medical director shall refer nonmedical grievances to the PCCM plan's grievance procedure pursuant to section 56260.
    (f) Actively participating in the functioning of the PCCM plan grievance procedures.
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 A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 7-9-90.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 A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed by operation of law on 11-6-90.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 A Certificate of Compliance must be transmitted to OAL by 3-6-91 or emergency language will be repealed by operation of law on the following day.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 A Certificate of Compliance must be transmitted to OAL by 7-23-91 or emergency language will be repealed by operation of law on the following day.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 section 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: Section 14088.16, Welfare and Institutions Code.