§ 56352. Contract Termination.

(a) The Department shall terminate a contract with a PCCM plan which the Secretary, Department of Health and Human Services has determined does not meet the requirements for participation in the Medicaid program stated in Title XIX of the Social Security Act.

(b) The Department may terminate a PCCM contract for noncompliance by the PCCM plan with the requirements of state or federal law or regulations or terms of the PCCM contract.

(c) The Department shall give 30 calendar days written notice prior to the termination of a PCCM contract to:

(1) The PCCM plan.

(2) PCCM plan members.

(3) Other entities, organizations, and persons that the Department deems appropriate.

(d) Notwithstanding subdivision (c), the contract shall be terminated immediately if the Department determines that:

(1) There is an immediate threat to the health of Medi-Cal beneficiaries enrolled in the PCCM plan; or,

(2) A state officer or state employee:

(A) Provides legal or management services to the PCCM plan, or

(B) Has a financial interest in:

1. The PCCM contract or PCCM contracting organization.

2. Any contract with the PCCM plan.

3. The procurement of a PCCM contract for the PCCM plan.

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 A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 7-9-90.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 A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed by operation of law on 11-6-90.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 A Certificate of Compliance must be transmitted to OAL by 3-6-91 or emergency language will be repealed by operation of law on the following day.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 A Certificate of Compliance must be transmitted to OAL by 7-23-91 or emergency language will be repealed by operation of law on the following day.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.