The criteria that the department shall use to identify providers to be placed on prior authorization for noninvasive testing procedures shall include, but not be limited to, Medi-Cal trend analysis, provider profiling data, provider and beneficiary history data, or appropriateness of the services as related to diagnosis, volume of services, utilization patterns, and specialty of provider. The existing prior authorization appeals process shall be available to these providers for denial of services.
Cal. Welf. & Inst. Code § 14133.14
The Medi-Cal Benefits Program
Known as the Medi-Cal Act
The act spans §§ 14000 to 14199.87 (1,239 sections).
Added by Stats. 1997, Ch. 294, Sec. 72
Official source: California Legislative Information. Reproduced from public-domain California statutes; confirm against the official source for the current text. Not legal advice.