A non-contract hospital providing emergency services to a Medi-Cal recipient and subsequently seeking reimbursement must provide a statement from the attending physician which includes: the nature of the emergency or life threatening condition inclusive of relevant clinical information, why the patient could not be stabilized and transferred to a contracting hospital and why the emergency services given were considered immediately required, and the signature of the physician.
The department may examine any of the books and records of applicants, providers, or person or entity providing goods or services and seeking reimbursement, to the extent necessary to carry out the listed provisions and regulations. Applicants, providers or others receiving or seeking reimbursement through the Medi-Cal program or other health care program must provide copies of records upon request by the department. The information provided shall only be used to investigate Medi-Cal fraud or abuse.
Renewal of nonemergency medical transportation services will be approved for up to one year if the patient received such services for the preceding 12 months, the renewal request is accompanied by a physician certification that the patient's condition is not likely to improve during such period, and the department finds the service is a medical necessity.
Adult day health care providers shall provide the department all additional information and reports that the department may find necessary in performing its functions, unless otherwise specified by an interagency agreement.
A local law enforcement agency must immediately report to the ombudsman program when the abuse is alleged to have occurred in a long-term care facility or to the county adult protective services if abuse occurred elsewhere. The law enforcement agency must also report the abuse to the agency responsible for investigating cases of elder and dependent adult abuse.
An adult protective services agency, a local law enforcement agency, or an ombudsman program receiving a report of elder or dependent adult abuse alleged to have occurred in a long-term care facility must report such information to the licensing agency.
An adult protective services agency, a local law enforcement agency, or an ombudsman program must report results of investigations of elder or dependent adult abuse to agencies that reported or referred the abuse incident.
A child educational advocate's duties includes locating the child's immunization and school health records and sending them to the school in which the child is to be enrolled and to the department so that the information can be included in the child's health passport.