§ 14079
166 words·~1 min read·
/ca/welfare-and-institutions-code/14079A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(a)The director shall periodically review the reimbursement levels for physician and dental services in the Medi-Cal fee-for-service delivery system, and shall periodically revise the rates of reimbursement to physicians and dentists to the extent the director deems necessary to comply with applicable federal Medicaid program requirements, including provisions on reasonable access to physician and dental services for Medi-Cal beneficiaries.
(b)To the extent consistent with the department’s federally approved access monitoring plan, or any successor methodology for monitoring reasonable access to Medi-Cal covered services, as described in Section 1396a(a)(30)(A) of Title 42 of the United States Code, this periodic review, as it relates to rates for physician services, shall take into account at least the following factors:
(1)Annual cost increases for physicians as reflected by the Consumer Price Index.
(2)Physician reimbursement levels under the Medicare Program.
(3)Prevailing customary physician charges within the state and in various geographical areas.
(4)Characteristics of the current population of Medi-Cal beneficiaries and the medical services needed.