Health and Safety Code — Part 36 | HSC — United States — California law | Esheria

Health and Safety Code

Part 36 of 87 · provisions 7,001–7,200

This section says the act is to be known as the Health and Safety Code.

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About this statute

The Legislature states findings supporting a unified, single-payer-style health care financing system for all Californians. The State Department of Health Services is renamed the State Department of Health Care Services, and its retained functions continue with the renamed department. The Director of Health Care Services is appointed by the Governor with Senate confirmation, the director receives a salary set by law, and the Governor may appoint up to two chief deputies on the director’s recommendation. The director has the powers of a department head under the cited Government Code chapter. The Department of Health Services has a Division of Rural Health, and that division must administer specified chapters and sections.

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Provisions of Health and Safety Code

Showing 200 of 17,333

  1. 1374.7.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5. Standards [1367 - 1374.198] ( Article 5 added by Stats. 1975, Ch. 941. )

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    A health plan must not deny enrollment or renewal, charge more, change terms, ask for genetic information for non-therapeutic purposes, or discriminate in solicitor fees because of genetic characteristics linked to disability.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5. Standards [1367 - 1374.198] ( Article 5 added by Stats. 1975, Ch. 941. ) ## 1374.7. (a) No plan shall refuse to enroll any person or accept any person as a subscriber or renew any person as a subscriber after appropriate application on the basis of a person’s genetic characteristics that may, under some circumstances, be associated with disability in that person or that person’s offspring. No plan shall require a higher rate or charge, or offer or provide different terms, conditions, or benefits, on the basis of a person’s genetic characteristics that may, under some circumstances, be associated with disability in that person or that person’s offspring. (b) No plan shall seek information about a person’s genetic characteristics for any nontherapeutic purpose. (c) No discrimination shall be made in the fees or commissions of a solicitor or solicitor firm for an enrollment or a subscription or the renewal of an enrollment or subscription of any person on the basis of a person’s genetic characteristics that may, under some circumstances, be associated with disability in that person or that person’s offspring. (d) “Genetic characteristics” as used in this section means either of the following: (1) Any scientifically or medically identifiable gene or chromosome, or combination or alteration thereof, that is known to be a cause of a disease or disorder in a person or his or her offspring, or that is determined to be associated with a statistically increased risk of development of a disease or disorder, and that is presently not associated with any symptoms of any disease or disorder. (2) Inherited characteristics that may derive from the individual or family member, that are known to be a cause of a disease or disorder in a person or his or her offspring, or that are determined to be associated with a statistically increased risk of development of a disease or disorder, and that are presently not associated with any symptoms of any disease or disorder. (Amended by Stats. 1999, Ch. 311, Sec. 3. Effective January 1, 2000.)
  2. 1374.71.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. )

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    Some plans are exempt from filing a notice of material modification for certain point-of-service contracts.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. ) ## 1374.71. No plan formerly registered under the Knox-Mills Health Plan Act (Article 2.5 (commencing with Section 12530) of Chapter 6 of Part 2 of Division 3 of Title 2 of the Government Code) in 1975 shall be required to file a notice of material modification under Section 1374.69 or 1374.70 for any point-of-service plan contract previously approved by the director under this chapter and offered by plan on or before September 1, 1993. (Amended by Stats. 1999, Ch. 525, Sec. 121. Effective January 1, 2000. Operative July 1, 2000, or sooner, by Sec. 214 of Ch. 525.)
  3. 1374.72.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. )

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    Health care service plans must cover medically necessary mental health and substance use disorder treatment for covered contracts, apply similar terms to those benefits as to other medical benefits, and cannot restrict them to short-term or acute care.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. ) ## 1374.72. (a) (1) Every health care service plan contract issued, amended, or renewed on or after January 1, 2021, that provides hospital, medical, or surgical coverage shall provide coverage for medically necessary treatment of mental health and substance use disorders, under the same terms and conditions applied to other medical conditions as specified in subdivision (c). (2) For purposes of this section, “mental health and substance use disorders” means a mental health condition or substance use disorder that falls under any of the diagnostic categories listed in the mental and behavioral disorders chapter of the most recent edition of the International Classification of Diseases or that is listed in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders. Changes in terminology, organization, or classification of mental health and substance use disorders in future versions of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders or the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems shall not affect the conditions covered by this section as long as a condition is commonly understood to be a mental health or substance use disorder by health care providers practicing in relevant clinical specialties. (3) (A) For purposes of this section, “medically necessary treatment of a mental health or substance use disorder” means a service or product addressing the specific needs of that patient, for the purpose of preventing, diagnosing, or treating an illness, injury, condition, or its symptoms, including minimizing the progression of that illness, injury, condition, or its symptoms, in a manner that is all of the following: (i) In accordance with the generally accepted standards of mental health and substance use disorder care. (ii) Clinically appropriate in terms of type, frequency, extent, site, and duration. (iii) Not primarily for the economic benefit of the health care service plan and subscribers or for the convenience of the patient, treating physician, or other health care provider. (B) This paragraph does not limit in any way the independent medical review rights of an enrollee or subscriber under this chapter. (4) For purposes of this section, “health care provider” means any of the following: (A) A person who is licensed under Division 2 (commencing with Section 500) of the Business and Professions Code. (B) An associate marriage and family therapist or marriage and family therapist trainee functioning pursuant to Section 4980.43.3 of the Business and Professions Code. (C) A qualified autism service provider certified by a national entity as defined in Section 4999.200 of the Business and Professions Code or a qualified autism service professional as defined in Section 4999.201 of the Business and Professions Code. (D) An associate clinical social worker functioning pursuant to Section 4996.23.2 of the Business and Professions Code. (E) An associate professional clinical counselor or professional clinical counselor trainee functioning pursuant to Section 4999.46.3 of the Business and Professions Code. (F) A registered psychologist, as described in Section 2909.5 of the Business and Professions Code. (G) A registered psychological associate, as described in Section 2913 of the Business and Professions Code. (H) A psychology trainee or person supervised as set forth in Section 2910 or 2911 of, or subdivision (d) of Section 2914 of, the Business and Professions Code. (5) For purposes of this section, “generally accepted standards of mental health and substance use disorder care” has the same meaning as defined in paragraph (1) of subdivision (f) of Section 1374.721. (6) A health care service plan shall not limit benefits or coverage for mental health and substance use disorders to short-term or acute treatment. (7) All medical necessity determinations by the health care service plan concerning service intensity, level of care placement, continued stay, and transfer or discharge of enrollees diagnosed with mental health and substance use disorders shall be conducted in accordance with the requirements of Section 1374.721. This paragraph does not deprive an enrollee of the other protections of this chapter, including, but not limited to, grievances, appeals, independent medical review, discharge, transfer, and continuity of care. (8) A health care service plan that authorizes a specific type of treatment by a provider pursuant to this section shall not rescind or modify the authorization after the provider renders the health care service in good faith and pursuant to this authorization for any reason, including, but not limited to, the plan’s subsequent rescission, cancellation, or modification of the enrollee’s or subscriber’s contract, or the plan’s subsequent determination that it did not make an accurate determination of the enrollee’s or subscriber’s eligibility. This section shall not be construed to expand or alter the benefits available to the enrollee or subscriber under a plan. (b) The benefits that shall be covered pursuant to this section shall include, but not be limited to, the following: (1) Basic health care services, as defined in subdivision (b) of Section 1345. (2) Intermediate services, including the full range of levels of care, including, but not limited to, residential treatment, partial hospitalization, and intensive outpatient treatment. (3) Prescription drugs, if the plan contract includes coverage for prescription drugs. (c) The terms and conditions applied to the benefits required by this section, that shall be applied equally to all benefits under the plan contract, shall include, but not be limited to, all of the following patient financial responsibilities: (1) Maximum annual and lifetime benefits, if not prohibited by applicable law. (2) Copayments and coinsurance. (3) Individual and family deductibles. (4) Out-of-pocket maximums. (d) If services for the medically necessary treatment of a mental health or substance use disorder are not available in network within the geographic and timely access standards set by law or regulation, the health care service plan shall arrange coverage to ensure the delivery of medically necessary out-of-network services and any medically necessary followup services that, to the maximum extent possible, meet those geographic and timely access standards. As used in this subdivision, to “arrange coverage to ensure the delivery of medically necessary out-of-network services” includes, but is not limited to, providing services to secure medically necessary out-of-network options that are available to the enrollee within geographic and timely access standards. The enrollee shall pay no more than the same cost sharing that the enrollee would pay for the same covered services received from an in-network provider. (e) This section shall not apply to contracts entered into pursuant to Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing with Section 14200) of Part 3 of Division 9 of the Welfare and Institutions Code, between the State Department of Health Care Services and a health care service plan for enrolled Medi-Cal beneficiaries. (f) (1) For the purpose of compliance with this section, a health care service plan may provide coverage for all or part of the mental health and substance use disorder services required by this section through a separate specialized health care service plan or mental health plan, and shall not be required to obtain an additional or specialized license for this purpose. (2) A health care service plan shall provide the mental health and substance use disorder coverage required by this section in its entire service area and in emergency situations as may be required by applicable laws and regulations. For purposes of this section, health care service plan contracts that provide benefits to enrollees through preferred provider contracting arrangements are not precluded from requiring enrollees who reside or work in geographic areas served by specialized health care service plans or mental health plans to secure all or part of their mental health services within those geographic areas served by specialized health care service plans or mental health plans, provided that all appropriate mental health or substance use disorder services are actually available within those geographic service areas within timeliness standards. (3) Notwithstanding any other law, in the provision of benefits required by this section, a health care service plan may utilize case management, network providers, utilization review techniques, prior authorization, copayments, or other cost sharing, provided that these practices are consistent with Section 1374.76 of this code, and Section 2052 of the Business and Professions Code. (g) This section shall not be construed to deny or restrict in any way the department’s authority to ensure plan compliance with this chapter. (h) A health care service plan shall not limit benefits or coverage for medically necessary services on the basis that those services should be or could be covered by a public entitlement program, including, but not limited to, special education or an individualized education program, Medicaid, Medicare, Supplemental Security Income, or Social Security Disability Insurance, and shall not include or enforce a contract term that excludes otherwise covered benefits on the basis that those services should be or could be covered by a public entitlement program. (i) A health care service plan shall not adopt, impose, or enforce terms in its plan contracts or provider agreements, in writing or in operation, that undermine, alter, or conflict with the requirements of this section. (Amended by Stats. 2025, Ch. 413, Sec. 4. (SB 402) Effective January 1, 2026.)
  4. 1374.721.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. )

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    Health care service plans covering hospital, medical, or surgical services must base mental health and substance use disorder medical-necessity review on current accepted standards and follow specified review criteria, training, documentation, and reliability requirements.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. ) ## 1374.721. (a) A health care service plan that provides hospital, medical, or surgical coverage shall base any medical necessity determination or the utilization review criteria that the plan, and any entity acting on the plan’s behalf, applies to determine the medical necessity of health care services and benefits for the diagnosis, prevention, and treatment of mental health and substance use disorders on current generally accepted standards of mental health and substance use disorder care. (b) In conducting utilization review of all covered health care services and benefits for the diagnosis, prevention, and treatment of mental health and substance use disorders in children, adolescents, and adults, a health care service plan shall apply the criteria and guidelines set forth in the most recent versions of treatment criteria developed by the nonprofit professional association for the relevant clinical specialty. (c) In conducting utilization review involving level of care placement decisions or any other patient care decisions that are within the scope of the sources specified in subdivision (b), a health care service plan shall not apply different, additional, conflicting, or more restrictive utilization review criteria than the criteria and guidelines set forth in those sources. This subdivision does not prohibit a health care service plan from applying utilization review criteria to health care services and benefits for mental health and substance use disorders that meet either of the following criteria: (1) Are outside the scope of the criteria and guidelines set forth in the sources specified in subdivision (b), provided the utilization review criteria were developed in accordance with subdivision (a). (2) Relate to advancements in technology or types of care that are not covered in the most recent versions of the sources specified in subdivision (b), provided that the utilization review criteria were developed in accordance with subdivision (a). (d) If a health care service plan purchases or licenses utilization review criteria pursuant to paragraph (1) or (2) of subdivision (c), the plan shall verify and document before use that the criteria were developed in accordance with subdivision (a). (e) To ensure the proper use of the criteria described in subdivision (b), every health care service plan shall do all of the following: (1) Sponsor a formal education program by nonprofit clinical specialty associations to educate the health care service plan’s staff, including any third parties contracted with the health care service plan to review claims, conduct utilization reviews, or make medical necessity determinations about the clinical review criteria. (2) Make the education program available to other stakeholders, including the health care service plan’s participating providers and covered lives. Participating providers shall not be required to participate in the education program. (3) Provide, at no cost, the clinical review criteria and any training material or resources to providers and health care service plan enrollees. (4) Track, identify, and analyze how the clinical review criteria are used to certify care, deny care, and support the appeals process. (5) Conduct interrater reliability testing to ensure consistency in utilization review decisionmaking covering how medical necessity decisions are made. This assessment shall cover all aspects of utilization review as defined in paragraph (3) of subdivision (f). (6) Run interrater reliability reports about how the clinical guidelines are used in conjunction with the utilization management process and parity compliance activities. (7) Achieve interrater reliability pass rates of at least 90 percent and, if this threshold is not met, immediately provide for the remediation of poor interrater reliability and interrater reliability testing for all new staff before they can conduct utilization review without supervision. (f) The following definitions apply for purposes of this section: (1) “Generally accepted standards of mental health and substance use disorder care” means standards of care and clinical practice that are generally recognized by health care providers practicing in relevant clinical specialties such as psychiatry, psychology, clinical sociology, addiction medicine and counseling, and behavioral health treatment pursuant to Section 1374.73. Valid, evidence-based sources establishing generally accepted standards of mental health and substance use disorder care include peer-reviewed scientific studies and medical literature, clinical practice guidelines and recommendations of nonprofit health care provider professional associations, specialty societies and federal government agencies, and drug labeling approved by the United States Food and Drug Administration. (2) “Mental health and substance use disorders” has the same meaning as defined in paragraph (2) of subdivision (a) of Section 1374.72. (3) “Utilization review” means either of the following: (A) Prospectively, retrospectively, or concurrently reviewing and approving, modifying, delaying, or denying, based in whole or in part on medical necessity, requests by health care providers, enrollees, or their authorized representatives for coverage of health care services prior to, retrospectively or concurrent with the provision of health care services to enrollees. (B) Evaluating the medical necessity, appropriateness, level of care, service intensity, efficacy, or efficiency of health care services, benefits, procedures, or settings, under any circumstances, to determine whether a health care service or benefit subject to a medical necessity coverage requirement in a health care service plan contract is covered as medically necessary for an enrollee. (4) “Utilization review criteria” means any criteria, standards, protocols, or guidelines used by a health care service plan to conduct utilization review. (g) This section applies to all health care services and benefits for the diagnosis, prevention, and treatment of mental health and substance use disorders covered by a health care service plan contract, including prescription drugs. (h) This section applies to a health care service plan that conducts utilization review as defined in this section, and any entity or contracting provider that performs utilization review or utilization management functions on behalf of a health care service plan. (i) The director may assess administrative penalties for violations of this section as provided for in Section 1368.04, in addition to any other remedies permitted by law. (j) A health care service plan shall not adopt, impose, or enforce terms in its plan contracts or provider agreements, in writing or in operation, that undermine, alter, or conflict with the requirements of this section. (k) This section does not apply to contracts entered into pursuant to Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing with Section 14200) of Part 3 of Division 9 of the Welfare and Institutions Code, between the State Department of Health Care Services and a health care service plan for enrolled Medi-Cal beneficiaries. (Added by Stats. 2020, Ch. 151, Sec. 5. (SB 855) Effective January 1, 2021.)
  5. 1374.722.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. )

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    Certain health care service plans must cover and reimburse schoolsite mental health and substance use disorder services, and they may not require prior authorization except as authorized by the department.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. ) ## 1374.722. (a) (1) A health care service plan contract issued, amended, renewed or delivered on or after January 1, 2024, that is required to provide coverage for medically necessary treatment of mental health and substance use disorders pursuant to Sections 1374.72, 1374.721, and 1374.73 shall cover the provision of the services identified in the fee-for-service reimbursement schedule published by the State Department of Health Care Services, as described in subparagraph (B) of paragraph (5) of subdivision (c), when those services are delivered at schoolsites pursuant to this section, regardless of the network status of the local educational agency, institution of higher education, or health care provider. (2) This section does not relieve a local educational agency or institution of higher education from requirements to accommodate or provide services to students with disabilities pursuant to any applicable state and federal law, including, but not limited to, the federal Individuals with Disabilities Education Act (20 U.S.C. Sec. 1400 et seq.), Part 30 (commencing with Section 56000) of Division 4 of Title 2 of the Education Code, Chapter 26.5 (commencing with Section 7570) of Division 7 of Title 1 of the Government Code, and Chapter 3 (commencing with Section 3000) of Division 1 of Title 5 of the California Code of Regulations. (b) The following definitions apply for purposes of this section: (1) “Health care provider” has the same meaning as defined in paragraph (4) of subdivision (a) of Section 1374.72 and paragraph (5) of subdivision (c) of Section 1374.73. (2) “Institution of higher education” means the California Community Colleges, the California State University, or the University of California. (3) “Local educational agency” means a school district, county office of education, charter school, the California Schools for the Deaf, and the California School for the Blind. (4) “Medically necessary treatment of a mental health or substance use disorder” has the same meaning as defined in paragraph (3) of subdivision (a) of Section 1374.72. (5) “Mental health and substance use disorder” has the same meaning as defined in paragraph (2) of subdivision (a) of Section 1374.72. (6) “School site” means a facility or location used for public kindergarten, elementary, secondary, or postsecondary purposes. “School site” also includes a location not owned or operated by a public school, or public school district, if the school or school district provides or arranges for the provision of medically necessary treatment of a mental health or substance use disorder to its students at that location, including off-campus clinics, mobile counseling services, and similar locations. (7) “Utilization review” has the same meaning as defined in paragraph (3) of subdivision (f) of Section 1374.721. (c) When a local educational agency or institution of higher education provides or arranges for the provision of treatment of a mental health or substance use disorder services subject to this section by a health care provider for an individual 25 years of age or younger at a school site, the student’s health care service plan shall reimburse the local educational agency or institution of higher education for those services. (1) A health care service plan shall not require prior authorization for services provided pursuant to this section. (2) A health care service plan may conduct a postclaim review to determine appropriate payment of the claim. Payment for services subject to this section may be denied only if the health care service plan reasonably determines that the services were provided to a student not enrolled in the health plan, were never performed, or were not provided by a health care provider appropriately licensed or authorized to provide the services. (3) Notwithstanding paragraph (1), a health plan may require prior authorization for services as authorized by the department pursuant to subdivision (d). (4) A local educational agency, community college district, the California State University system, or the Regents of the University of California may consolidate claims for purposes of submitting the claims to a health care service plan. (5) A health care service plan shall provide reimbursement for services provided to students pursuant to this section at the greater of either of the following amounts: (A) The health plan’s contracted rate with the local educational agency, institution of higher education, or health care provider, if any. (B) The fee-for-service reimbursement rate published by the State Department of Health Care Services for the same or similar services provided in an outpatient setting, pursuant to Section 5961.4 of the Welfare and Institutions Code. (6) A health care service plan shall provide reimbursement for services provided pursuant to this section in compliance with the requirements for timely payment of claims, as required by this chapter. (7) Services provided pursuant to this section shall not be subject to copayment, coinsurance, deductible, or any other form of cost sharing. (8) An individual or entity shall not bill the enrollee or subscriber, nor seek reimbursement from the enrollee or subscriber, for services provided pursuant to this section. (d) No later than December 31, 2023, the director shall issue guidance to health care service plans regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). Any guidance issued pursuant to this subdivision shall be effective only until the director adopts regulations pursuant to the Administrative Procedure Act. (e) This section does not apply to contracts entered into pursuant to Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing with Section 14200) of Part 3 of Division 9 of the Welfare and Institutions Code, between the State Department of Health Care Services and a health care service plan for enrolled Medi-Cal beneficiaries. (Added by Stats. 2021, Ch. 143, Sec. 13. (AB 133) Effective July 27, 2021.)
  6. 1374.723.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. )

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    Health care service plans must cover certain CARE-related services, cannot require prior authorization for them in most cases, and must limit billing and cost sharing for those services.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. ) ## 1374.723. (a) A health care service plan contract issued, amended, renewed, or delivered on or after July 1, 2023, that covers hospital, medical, or surgical expenses shall cover the cost of developing an evaluation pursuant to Section 5977.1 of the Welfare and Institutions Code and the provision of all health care services for an enrollee when required or recommended for the enrollee pursuant to a CARE agreement or a CARE plan approved by a court in accordance with the court’s authority under Sections 5977.1, 5977.2, 5977.3, and 5982 of the Welfare and Institutions Code, regardless of whether the service is provided by an in-network or out-of-network provider. (b) (1) A health care service plan shall not require prior authorization for services, other than prescription drugs, provided pursuant to a CARE agreement or CARE plan approved by a court pursuant to Part 8 (commencing with Section 5970) of Division 5 of the Welfare and Institutions Code. (2) A health care service plan may conduct a postclaim review to determine appropriate payment of a claim. Payment for services subject to this section may be denied only if the health care service plan reasonably determines the enrollee was not enrolled with the plan at the time the services were rendered, the services were never performed, or the services were not provided by a health care provider appropriately licensed or authorized to provide the services. (3) Notwithstanding paragraph (1), a health care service plan may require prior authorization for services as permitted by the department pursuant to subdivision (e). (c) (1) A health care service plan shall provide for reimbursement of services provided to an enrollee pursuant to this section, other than prescription drugs, at the greater of either of the following amounts: (A) The health plan’s contracted rate with the provider. (B) The fee-for-service or case reimbursement rate paid in the Medi-Cal program for the same or similar services as identified by the State Department of Health Care Services. (2) A health care service plan shall provide for reimbursement of prescription drugs provided to an enrollee pursuant to this section at the health care service plan’s contracted rate. (3) A health care service plan shall provide reimbursement for services provided pursuant to this section in compliance with the requirements for timely payment of claims, as required by this chapter. (d) Services provided to an enrollee pursuant to a CARE agreement or CARE plan, excluding prescription drugs, shall not be subject to copayment, coinsurance, deductible, or any other form of cost sharing. An individual or entity shall not bill the enrollee or subscriber, nor seek reimbursement from the enrollee or subscriber, for services provided pursuant to a CARE agreement or CARE plan, regardless of whether the service is delivered by an in-network or out-of-network provider. (e) No later than July 1, 2023, the department may issue guidance to health care service plans regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). Guidance issued pursuant to this subdivision shall be effective only until the department adopts regulations pursuant to the Administrative Procedure Act. (f) This section does not excuse a health care service plan from complying with Section 1374.72. (g) This section does not apply to Medi-Cal managed care contracts entered pursuant to Chapter 7 (commencing with Section 14000), Chapter 8 (commencing with Section 14200), or Chapter 8.75 (commencing with Section 14591) of Part 3 of Division 9 of the Welfare and Institutions Code, between the State Department of Health Care Services and a health care service plan for enrolled Medi-Cal beneficiaries. (h) This section shall become operative on July 1, 2023. (Added by Stats. 2022, Ch. 319, Sec. 2. (SB 1338) Effective January 1, 2023. Operative July 1, 2023, by its own provisions.)
  7. 1374.724.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. )

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    Health care service plans must cover and reimburse certain behavioral health crisis services, cannot require prior authorization in specified cases, and must handle transfer and contact-number duties within set timeframes.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. ) ## 1374.724. (a) Coverage of mental health and substance use disorder treatment pursuant to Section 1374.72 includes behavioral health crisis services that are provided to an enrollee by a 988 center, mobile crisis team, or other provider of behavioral health crisis services, as set forth in Chapter 1 (commencing with Section 53000) of Part 1 of Division 2 of Title 5 of the Government Code, regardless of whether the service is provided by an in-network or out-of-network provider or facility. With respect to behavioral health crisis services provided to an enrollee by a 988 center or mobile crisis team, a health care service plan shall cover, at a minimum, all items and services that are eligible for coverage under the Medi-Cal program. (b) (1) A health care service plan shall not require prior authorization for behavioral health crisis stabilization services and care provided by a 988 center, mobile crisis team, or other provider of behavioral health crisis services to an enrollee pursuant to Chapter 1 (commencing with Section 53000) of Part 1 of Division 2 of Title 5 of the Government Code. (2) Notwithstanding any other law, payment for behavioral health crisis stabilization services and care pursuant to this section shall not be denied unless the health care service plan, or its contracting medical provider, reasonably determines that the services were never performed. (3) If its prior authorization requirements comply with Section 1374.721, a health care service plan may require prior authorization as a prerequisite for payment for medically necessary mental health or substance use disorder services following stabilization from a behavioral health crisis addressed by services provided through the 988 system. If there is a disagreement between the health care service plan and the behavioral health crisis service provider or facility regarding the need for medically necessary mental health or substance use disorder services following stabilization of the enrollee, the plan shall assume responsibility for the care of the enrollee by arranging for services for the enrollee pursuant to Section 1374.72 at a level of care consistent with utilization review criteria pursuant to Section 1374.721. (4) A health care service plan shall not require, under any circumstances, a behavioral health crisis services provider or facility to discharge or transfer an enrollee before stabilization has occurred or before utilization review consistent with Section 1374.721. (c) (1) A health care service plan that is contacted by a 988 center, mobile crisis team, or other provider of behavioral health crisis services shall, within 30 minutes of the time the provider makes the initial telephone call requesting information, either authorize poststabilization care or inform the provider that it will arrange for the prompt transfer of the enrollee’s care to another provider. (2) A health care service plan that is contacted by a 988 center, mobile crisis team, or other provider of behavioral health crisis services shall reimburse the provider for poststabilization care rendered to the enrollee if any of the following occur: (A) The health care service plan authorized the 988 center, mobile crisis team, or other provider of behavioral health crisis services to provide poststabilization care. (B) The health care service plan did not respond to the provider’s initial contact or did not make a decision regarding whether to authorize poststabilization care or to promptly transfer the enrollee’s care within the timeframe set forth in paragraph (1). (C) There is an unreasonable delay in the transfer of the enrollee’s care to another provider, and the provider determines that the enrollee requires poststabilization care. (3) A health care service plan shall prominently display on its internet website the specific telephone number for noncontracting providers to obtain prompt authorization for the transfer of a stabilized enrollee’s care to another provider or authorization to provide poststabilization care. The health care service plan shall ensure the telephone number published on its internet website is the correct telephone number for purposes of this paragraph. The health care service plan shall update the telephone number on the plan’s internet website within one business day if the telephone number changes. A health care service plan shall provide the telephone number to the department, and the department shall post the telephone number on its internet website. (4) To the extent permissible under federal law, a health care service plan shall not require a 988 center, mobile crisis team, or other provider of behavioral health crisis services to make more than one telephone call to the number provided in advance by the health care service plan. The representative of the 988 center, mobile crisis team, or other provider of behavioral health crisis services that makes the telephone call may be, but is not required to be, a physician or surgeon. (5) A 988 center, mobile crisis team, or other provider of behavioral health crisis services shall not bill a patient who is an enrollee of a health care service plan for poststabilization care, except for the in-network cost-sharing amount as defined in paragraph (2) of subdivision (d). An enrollee who is billed in violation of this section may report receipt of the bill to the health care service plan and the department. The department shall forward that report to the State Department of Public Health. (d) (1) Notwithstanding subdivision (f) of Section 1371.4, a health care service plan shall reimburse a 988 center, mobile crisis team, or other provider of behavioral health crisis services for emergency and nonemergency behavioral health crisis services and care pursuant to this section, consistent with the requirements of Section 1371.4 and any other applicable requirement of this chapter. (2) If an enrollee receives services and care pursuant to this section from a 988 center, mobile crisis team, or other provider of behavioral health crisis services outside the plan network, the enrollee shall pay no more than the same cost sharing that the enrollee would pay for the same services received from an in-network provider. This amount shall be referred to as the “in-network cost-sharing amount.” An out-of-network 988 center, mobile crisis team, or other provider of behavioral health crisis services shall not bill or collect an amount from the enrollee for services subject to this section except for the in-network cost-sharing amount. (e) For purposes of this section: (1) “Behavioral health crisis services” has the same meaning as set forth in Section 53123.1.5 of the Government Code. (2) “Behavioral health crisis stabilization services” means the services necessary to determine if a behavioral health crisis exists and, if a behavioral health crisis does exist, the care and treatment that is necessary to stabilize the behavioral health crisis within the capability of the 988 center, mobile crisis team, or other provider of behavioral health crisis services. (3) “Poststabilization care” means medically necessary care provided after a behavioral health crisis has been stabilized. (4) An enrollee is “stabilized” or “stabilization” has occurred when, in the opinion of the treating provider or facility, the enrollee’s condition is such that, within reasonable medical probability, both of the following criteria are satisfied: (A) Material deterioration of the enrollee’s condition is unlikely to result from, or occur during, the discharge or transfer of the enrollee to the care of another provider. (B) The enrollee is able to safely travel from the site of care using nonmedical transportation or nonemergency medical transportation. The health care service plan shall continue to cover all services and care as behavioral health crisis stabilization services and care until the enrollee is discharged or transferred. (f) This section does not excuse a health care service plan from complying with Section 1374.72 or any other requirement of this chapter. (g) This section does not apply to Medi-Cal managed care contracts entered pursuant to Chapter 7 (commencing with Section 14000), Chapter 8 (commencing with Section 14200), or Chapter 8.75 (commencing with Section 14591) of Part 3 of Division 9 of the Welfare and Institutions Code between the State Department of Health Care Services and a health care service plan for enrolled Medi-Cal beneficiaries. (Amended by Stats. 2023, Ch. 42, Sec. 17. (AB 118) Effective July 10, 2023.)
  8. 1374.725.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. )

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    A covered health care service plan and its delegates must create a reimbursement process for providers of integrated mental health and substance use disorder treatment services.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. ) ## 1374.725. For services provided to an enrollee under a health care service plan contract issued, amended, or renewed on or after July 1, 2025, a health care service plan subject to Section 1374.72, and its delegates, shall establish a process to reimburse providers for mental health and substance use disorder treatment services that are integrated with primary care services. A process required under this section may be based upon federal rules or guidance issued for the Medicare program. (Added by Stats. 2024, Ch. 135, Sec. 1. (SB 1320) Effective January 1, 2025.)
  9. 1374.73.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. )

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    Health care service plans covering hospital, medical, or surgical care must cover behavioral health treatment for autism or pervasive developmental disorder, keep an adequate provider network, and cannot require a rediagnosis to keep that coverage in newer contracts.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. ) ## 1374.73. (a) (1) Every health care service plan contract that provides hospital, medical, or surgical coverage shall also provide coverage for behavioral health treatment for pervasive developmental disorder or autism no later than July 1, 2012. The coverage shall be provided in the same manner and is subject to the same requirements as provided in Section 1374.72. (2) Notwithstanding paragraph (1), as of the date that the proposed final rulemaking for essential health benefits is issued, this section does not require any benefits to be provided that exceed the essential health benefits that all health plans will be required by federal regulations to provide under Section 1302(b) of the federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152). (3) This section does not affect services for which an individual is eligible pursuant to Division 4.5 (commencing with Section 4500) of the Welfare and Institutions Code or Title 14 (commencing with Section 95000) of the Government Code. (4) This section does not affect or reduce any obligation to provide services under an individualized education program, as defined in Section 56032 of the Education Code, or an individual service plan, as described in Section 5600.4 of the Welfare and Institutions Code, or under the federal Individuals with Disabilities Education Act (20 U.S.C. Sec. 1400 et seq.) and its implementing regulations. (b) Every health care service plan subject to this section shall maintain an adequate network that includes qualified autism service providers who supervise or employ qualified autism service professionals or paraprofessionals who provide and administer behavioral health treatment. A health care service plan is not prevented from selectively contracting with providers within these requirements. (c) (1) A health care service plan contract issued, amended, or renewed on or after January 1, 2026, shall not require an enrollee previously diagnosed with pervasive developmental disorder or autism to receive a rediagnosis to maintain coverage for behavioral health treatment for pervasive developmental disorder or autism. (2) This subdivision does not prohibit or restrict a treating provider from reevaluating an enrollee for purposes of determining the appropriate treatment. The treatment plan shall be made available to the health care service plan upon request. (3) This subdivision does not prohibit a treating provider from prescribing a rediagnosis at the discretion of the physician licensed pursuant to Chapter 5 (commencing with Section 2000) of Division 2 of the Business and Professions Code or a psychologist licensed pursuant to Chapter 6.6 (commencing with Section 2900) of Division 2 of the Business and Professions Code. (4) A health care service plan shall not discontinue or delay existing treatment while waiting for a rediagnosis to be completed. (5) This subdivision does not prohibit a health care service plan from requiring utilization review. For the purpose of this section, utilization review is distinct from a rediagnosis. (d) For the purposes of this section, the following definitions shall apply: (1) “Behavioral health treatment” means professional services and treatment programs, including applied behavior analysis and evidence-based behavior intervention programs, that develop or restore, to the maximum extent practicable, the functioning of an individual with pervasive developmental disorder or autism and that meet all of the following criteria: (A) The treatment is prescribed by a physician and surgeon licensed pursuant to Chapter 5 (commencing with Section 2000) of, or is developed by a psychologist licensed pursuant to Chapter 6.6 (commencing with Section 2900) of, Division 2 of the Business and Professions Code. (B) The treatment is provided under a treatment plan prescribed by a qualified autism service provider and is administered by one of the following: (i) A qualified autism service provider. (ii) A qualified autism service professional supervised by the qualified autism service provider. (iii) A qualified autism service paraprofessional supervised by a qualified autism service provider or qualified autism service professional. (C) The treatment plan has measurable goals over a specific timeline that is developed and approved by the qualified autism service provider for the specific patient being treated. The treatment plan shall be reviewed no less than once every six months by the qualified autism service provider and modified whenever appropriate, and shall be consistent with Section 4686.2 of the Welfare and Institutions Code pursuant to which the qualified autism service provider does all of the following: (i) Describes the patient’s behavioral health impairments or developmental challenges that are to be treated. (ii) Designs an intervention plan that includes the service type, number of hours, and parent participation needed to achieve the plan’s goal and objectives, and the frequency at which the patient’s progress is evaluated and reported. (iii) Provides intervention plans that utilize evidence-based practices, with demonstrated clinical efficacy in treating pervasive developmental disorder or autism. (iv) Discontinues intensive behavioral intervention services when the treatment goals and objectives are achieved or no longer appropriate. (D) The treatment plan is not used for purposes of providing or for the reimbursement of respite, daycare, or educational services and is not used to reimburse a parent for participating in the treatment program. The treatment plan shall be made available to the health care service plan upon request. (2) “Qualified autism service provider” means an individual described in Section 4999.200 of the Business and Professions Code. (3) “Qualified autism service professional” means an individual who meets all of the criteria set forth in Section 4999.201 of the Business and Professions Code. (4) “Qualified autism service paraprofessional” means an unlicensed and uncertified individual who meets all of the criteria set forth in Section 4999.202 of the Business and Professions Code. (5) “Rediagnosis” means a subsequent undertaking by any method, device, or procedure, whether gratuitous or not, to ascertain or establish if a person is suffering from a physical or mental health disorder, pursuant to Section 2038 of the Business and Professions Code. “Rediagnosis” also means prescription of a subsequent diagnosis of pervasive developmental disorders or autism to ascertain or establish if a person is suffering from a pervasive developmental disorder or autism. (6) “Utilization review” means utilization review or utilization management functions that prospectively, retrospectively, or concurrently review and approve, modify, or deny, based in whole or in part on medical necessity to cure and relieve, treatment recommendations by physicians licensed pursuant to Chapter 5 (commencing with Section 2000) of Division 2 of the Business and Professions Code before, after, or concurrent with the provision of medical treatment services. “Utilization review” refers to an evaluation of existing treatment to ensure an enrollee receives the proper care at the proper time. (e) This section does not apply to either of the following: (1) A specialized health care service plan that does not deliver mental health or behavioral health services to enrollees. (2) A health care service plan contract in the Medi-Cal program (Chapter 7 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code). (f) This section does not limit the obligation to provide services under Section 1374.72. (g) As provided in Section 1374.72 and in paragraph (1) of subdivision (a), in the provision of benefits required by this section, a health care service plan may utilize case management, network providers, utilization review techniques, prior authorization, copayments, or other cost sharing. (Amended by Stats. 2025, Ch. 413, Sec. 5.5. (SB 402) Effective January 1, 2026.)
  10. 1374.74.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. )

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    The department must create an Autism Advisory Task Force by February 1, 2012, and later submit the task force’s report by December 31, 2012.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. ) ## 1374.74. (a) The department, in consultation with the Department of Insurance, shall convene an Autism Advisory Task Force by February 1, 2012, in collaboration with other agencies, departments, advocates, autism experts, health plan and health insurer representatives, and other entities and stakeholders that it deems appropriate. The Autism Advisory Task Force shall develop recommendations regarding behavioral health treatment that is medically necessary for the treatment of individuals with autism or pervasive developmental disorder. The Autism Advisory Task Force shall address all of the following: (1) Interventions that have been scientifically validated and have demonstrated clinical efficacy. (2) Interventions that have measurable treatment outcomes. (3) Patient selection, monitoring, and duration of therapy. (4) Qualifications, training, and supervision of providers. (5) Adequate networks of providers. (b) The Autism Advisory Task Force shall also develop recommendations regarding the education, training, and experience requirements that unlicensed individuals providing autism services shall meet in order to secure a license from the state. (c) The department shall submit a report of the Autism Advisory Task Force to the Governor, the President pro Tempore of the Senate, the Speaker of the Assembly, and the Senate and Assembly Committees on Health by December 31, 2012, on which date the task force shall cease to exist. (Amended by Stats. 2012, Ch. 162, Sec. 82. (SB 1171) Effective January 1, 2013.)
  11. 1374.75.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5. Standards [1367 - 1374.198] ( Article 5 added by Stats. 1975, Ch. 941. )

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    A health care service plan may not deny or alter coverage, or charge a different rate, because a person is or may be a victim of domestic violence.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5. Standards [1367 - 1374.198] ( Article 5 added by Stats. 1975, Ch. 941. ) ## 1374.75. (a) No health care service plan shall deny, refuse to enroll, refuse to renew, cancel, restrict, or otherwise terminate, exclude, or limit coverage, or charge a different rate for the same coverage, on the basis that the applicant or covered person is, has been, or may be a victim of domestic violence. (b) Nothing in this section shall prevent a health care service plan from underwriting coverage on the basis of the medical condition of an individual so long as the consideration of the condition (1) does not take into account whether such an individual’s medical condition was caused by an act of domestic violence, (2) is the same with respect to an applicant or enrollee who is not the subject of domestic violence as with an applicant or enrollee who is the subject of domestic violence, and (3) does not violate any other act, regulation, or rule of law. The fact that an individual is, has been, or may be the subject of domestic violence shall not be considered a medical condition. (c) As used in this section, “domestic violence” means domestic violence, as defined in Section 6211 of the Family Code. (Added by Stats. 1995, Ch. 603, Sec. 1. Effective January 1, 1996.)
  12. 1374.76.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. )

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    Health plan contracts must cover mental health and substance use disorder benefits in compliance with specified federal and state rules by January 1, 2015. The director may issue compliance guidance until January 1, 2016, and the department must consult with the Department of Insurance when doing so.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60 - 1374.76] ( Article 5.6 added by Stats. 1993, Ch. 987, Sec. 3. ) ## 1374.76. (a) No later than January 1, 2015, a large group health care service plan contract shall provide all covered mental health and substance use disorder benefits in compliance with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (Public Law 110-343) and all rules, regulations, and guidance issued pursuant to Section 2726 of the federal Public Health Service Act (42 U.S.C. Sec. 300gg-26). (b) No later than January 1, 2015, an individual or small group health care service plan contract shall provide all covered mental health and substance use disorder benefits in compliance with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (Public Law 110-343), all rules, regulations, and guidance issued pursuant to Section 2726 of the federal Public Health Service Act (42 U.S.C. Sec. 300gg-26), and Section 1367.005. (c) Until January 1, 2016, the director may issue guidance to health care service plans regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). Any guidance issued pursuant to this subdivision shall be effective only until the director adopts regulations pursuant to the Administrative Procedure Act. The department shall consult with the Department of Insurance in issuing guidance under this subdivision. (Added by Stats. 2014, Ch. 31, Sec. 8. (SB 857) Effective June 20, 2014.)
  13. 1374.8.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5. Standards [1367 - 1374.198] ( Article 5 added by Stats. 1975, Ch. 941. )

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    A health care service plan generally may not disclose information to an employer if it would identify an employee as receiving covered services, unless the employee authorizes it.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5. Standards [1367 - 1374.198] ( Article 5 added by Stats. 1975, Ch. 941. ) ## 1374.8. (a) A health care service plan shall not release any information to an employer that would directly or indirectly indicate to the employer that an employee is receiving or has received services from a health care provider covered by the plan unless authorized to do so by the employee. An insurer that has, pursuant to an agreement, assumed the responsibility to pay compensation pursuant to Article 3 (commencing with Section 3750) of Chapter 4 of Part 1 of Division 4 of the Labor Code, shall not be considered an employer for the purposes of this section. (b) Nothing in this section prohibits a health care service plan from releasing relevant information described in this section for the purposes set forth in Chapter 12 (commencing with Section 1871) of Part 2 of Division 1 of the Insurance Code. (c) Nothing in this section prohibits a health care service plan from releasing relevant information described in this section for the purposes set forth in Section 1385.10. (Amended by Stats. 2014, Ch. 577, Sec. 1. (SB 1182) Effective January 1, 2015.)
  14. 1374.9.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5. Standards [1367 - 1374.198] ( Article 5 added by Stats. 1975, Ch. 941. )

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    The director may impose administrative penalties on a health care service plan that violates Section 1374.7 or related rules/orders, after notice and a hearing.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 5. Standards [1367 - 1374.198] ( Article 5 added by Stats. 1975, Ch. 941. ) ## 1374.9. For violations of Section 1374.7, the director may, after appropriate notice and opportunity for hearing, by order, levy administrative penalties as follows: (a) Any health care service plan that violates Section 1374.7, or that violates any rule or order adopted or issued pursuant to this section, is liable for administrative penalties of not less than five thousand dollars ($5,000) for each first violation, and of not less than ten thousand dollars ($10,000) nor more than twenty thousand dollars ($20,000) for each second violation, and of not less than thirty thousand dollars ($30,000) and not more than two hundred thousand dollars ($200,000) for each subsequent violation. (b) The administrative penalties shall be paid to the Managed Care Administrative Fines and Penalties Fund and shall be used for the purposes specified in Section 1341.45. (c) The administrative penalties available to the director pursuant to this section are not exclusive, and may be sought and employed in any combination with civil, criminal, and other administrative remedies deemed advisable by the director to enforce the provisions of this chapter. (d) Commencing January 1, 2028, and every five years thereafter, the penalty amounts specified in this section shall be adjusted based on the average rate of change in premium rates for the individual and small group markets, and weighted by enrollment, since the previous adjustment. (Amended by Stats. 2022, Ch. 985, Sec. 2. (SB 858) Effective January 1, 2023.)
  15. 1375.1.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    Every health care service plan must show the director that it has financial soundness, assumes full financial risk with stated exceptions, and has a prompt claims payment or denial procedure.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1375.1. (a) Every plan shall have and shall demonstrate to the director that it has all of the following: (1) A fiscally sound operation and adequate provision against the risk of insolvency. (2) Assumed full financial risk on a prospective basis for the provision of covered health care services, except that a plan may obtain insurance or make other arrangements for the cost of providing to any subscriber or enrollee covered health care services, the aggregate value of which exceeds five thousand dollars ($5,000) in any year, for the cost of covered health care services provided to its members other than through the plan because medical necessity required their provision before they could be secured through the plan, and for not more than 90 percent of the amount by which its costs for any of its fiscal years exceed 115 percent of its income for that fiscal year. (3) A procedure for prompt payment or denial of provider and subscriber or enrollee claims, including those telehealth services, as defined in subdivision (a) of Section 2290.5 of the Business and Professions Code, covered by the plan. Except as provided in Section 1371, a procedure meeting the requirements of Subchapter G of the regulations (29 C.F.R. Part 2560) under Public Law 93-406 (88 Stats. 829-1035, 29 U.S.C. Secs. 1001 et seq.) shall satisfy this requirement. (b) In determining whether the conditions of this section have been met, the director shall consider, but not be limited to, the following: (1) The financial soundness of the plan’s arrangements for health care services and the schedule of rates and charges used by the plan. (2) The adequacy of working capital. (3) Agreements with providers for the provision of health care services. (c) For the purposes of this section, “covered health care services” means health care services provided under all plan contracts. (Amended by Stats. 2012, Ch. 782, Sec. 7. (AB 1733) Effective January 1, 2013.)
  16. 1375.2.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    Plans operating under a transitional license must have a fiscally sound operation on and after October 1, 1977.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1375.2. On and after October 1, 1977, every plan operating under a transitional license shall have a fiscally sound operation. (Added by Stats. 1977, Ch. 818.)
  17. 1375.3.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    A health care service plan must meet and confer with the director before filing for bankruptcy, notify the department when filing, and provide requested information on continuity of care.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1375.3. (a) A health care service plan shall meet and confer with the director and his or her designated representatives at least 10 business days prior to filing a petition commencing a case for bankruptcy under Title 11 of the United States Code, except under extraordinary circumstances. If extraordinary circumstances preclude a meet and confer with the director within the 10-day time period prior to the filing of a petition for bankruptcy, the plan shall meet and confer with the department at least 24 hours prior to filing the petition. A plan shall notify the department concurrently upon filing the petition. These meetings shall be deemed confidential. (b) At the director’s request, a plan shall provide within the time period specified by the department, information to assist in ensuring continuity of care and uninterrupted access to health care services for plan subscribers and enrollees. The information may include, but is not limited to, the following: (1) A list of all providers with which the plan contracts and material information regarding the contracts including, but not limited to, the grounds for termination of the contract and the term remaining on the contract. (2) A list of employer groups who subscribe with the plan. (3) A list of the enrollees of the plan. (4) A list of enrollees undergoing current treatment and a description of the authorized treatment for the enrollee. (5) A list of all brokers and agents involved in the negotiation of subscriber contracts. (6) A list of all enrollees who contract as individual subscribers for coverage by the plan. (c) Notwithstanding subdivision (a), nothing in this section shall preclude the director from exercising powers and duties authorized under this chapter. (Added by Stats. 2002, Ch. 928, Sec. 2. Effective January 1, 2003.)
  18. 1375.4.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    Health care service plan contracts with risk-bearing organizations must include specified financial and reporting terms, and the director must adopt implementing regulations.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1375.4. (a) Every contract between a health care service plan and a risk-bearing organization that is issued, amended, renewed, or delivered in this state on or after July 1, 2000, shall include provisions concerning the following, as to the risk-bearing organization’s administrative and financial capacity, which shall be effective as of January 1, 2001: (1) A requirement that the risk-bearing organization furnish financial information to the health care service plan or the plan’s designated agent and meet any other financial requirements that assist the health care service plan in maintaining the financial viability of its arrangements for the provision of health care services in a manner that does not adversely affect the integrity of the contract negotiation process. (2) A requirement that the health care service plan disclose information to the risk-bearing organization that enables the risk-bearing organization to be informed regarding the financial risk assumed under the contract. (3) A requirement that the health care service plans provide payments of all risk arrangements, excluding capitation, within 180 days after close of the fiscal year. (b) In accordance with subdivision (a) of Section 1344, the director shall adopt regulations on or before June 30, 2000, to implement this section which shall, at a minimum, provide for the following: (1) (A) A process for reviewing or grading risk-bearing organizations based on the following criteria: (i) The risk-bearing organization meets criterion 1 if it reimburses, contests, or denies claims for health care services it has provided, arranged, or for which it is otherwise financially responsible in accordance with the timeframes and other requirements described in Section 1371 and in accordance with any other applicable state and federal laws and regulations. (ii) The risk-bearing organization meets criterion 2 if it estimates its liability for incurred but not reported claims pursuant to a method that has not been held objectionable by the director, records the estimate at least quarterly as an accrual in its books and records, and appropriately reflects this accrual in its financial statements. (iii) The risk-bearing organization meets criterion 3 if it maintains at all times a positive tangible net equity, as defined in subdivision (e) of Section 1300.76 of Title 28 of the California Code of Regulations. (iv) The risk-bearing organization meets criterion 4 if it maintains at all times a positive level of working capital (excess of current assets over current liabilities). (B) A risk-bearing organization may reduce its liabilities for purposes of calculating tangible net equity, pursuant to clause (iii) of subparagraph (A), and working capital, pursuant to clause (iv) of subparagraph (A), by the amount of any liabilities the payment of which is guaranteed by a sponsoring organization pursuant to a qualified guarantee. A sponsoring organization is one that has a tangible net equity of a level to be established by the director that is in excess of all amounts that it has guaranteed to any person or entity. A qualified guarantee is one that meets all of the following: (i) It is approved by a board resolution of the sponsoring organization. (ii) The sponsoring organization agrees to submit audited annual financial statements to the plan within 120 days of the end of the sponsoring organization’s fiscal year. (iii) The guarantee is unconditional except for a maximum monetary limit. (iv) The guarantee is not limited in duration with respect to liabilities arising during the term of the guarantee. (v) The guarantee provides for six months’ advance notice to the plan prior to its cancellation. (2) The information required from risk-bearing organizations to assist in reviewing or grading these risk-bearing organizations, including balance sheets, claims reports, and designated annual, quarterly, or monthly financial statements prepared in accordance with generally accepted accounting principles, to be used in a manner, and to the extent necessary, provided to a single external party as approved by the director to the extent that it does not adversely affect the integrity of the contract negotiation process between the health care service plan and the risk-bearing organizations. (3) Audits to be conducted in accordance with generally accepted auditing standards and in a manner that avoids duplication of review of the risk-bearing organization. (4) A process for corrective action plans, as mutually agreed upon by the health care service plan and the risk-bearing organization and as approved by the director, for cases where the review or grading indicates deficiencies that need to be corrected by the risk-bearing organization, and contingency plans to ensure the delivery of health care services if the corrective action fails. The corrective action plan shall be approved by the director and standardized, to the extent possible, to meet the needs of the director and all health care service plans contracting with the risk-bearing organization. If the health care service plan and the risk-bearing organization are unable to determine a mutually agreeable corrective action plan, the director shall determine the corrective action plan. (5) The disclosure of information by health care service plans to the risk-bearing organization that enables the risk-bearing organization to be informed regarding the risk assumed under the contract, including: (A) Enrollee information monthly. (B) Risk arrangement information, information pertaining to any pharmacy risk assumed under the contract, information regarding incentive payments, and information on income and expenses assigned to the risk-bearing organization quarterly. (6) Periodic reports from each health care service plan to the director that include information concerning the risk-bearing organizations and the type and amount of financial risk assumed by them, and, if deemed necessary and appropriate by the director, a registration process for the risk-bearing organizations. (7) The confidentiality of financial and other records to be produced, disclosed, or otherwise made available, unless as otherwise determined by the director. (c) The failure by a health care service plan to comply with the contractual requirements pursuant to this section shall constitute grounds for disciplinary action. The director shall, as appropriate, within 60 days after receipt of documented violation from a risk-bearing organization, investigate and take enforcement action against a health care service plan that fails to comply with these requirements and shall periodically evaluate contracts between health care service plans and risk-bearing organizations to determine if any audit, evaluation, or enforcement actions should be undertaken by the department. (d) The Financial Solvency Standards Board established in Section 1347.15 shall study and report to the director on or before January 1, 2001, regarding all of the following: (1) The feasibility of requiring that there be in force insurance coverage commensurate with the financial risk assumed by the risk-bearing organization to protect against financial losses. (2) The appropriateness of different risk-bearing arrangements between health care service plans and risk-bearing organizations. (3) The appropriateness of the four criteria specified in paragraph (1) of subdivision (b). (e) This section shall not apply to specialized health care service plans. (f) For purposes of this section, “provider organization” means a medical group, independent practice association, or other entity that delivers, furnishes, or otherwise arranges for or provides health care services, but does not include an individual or a plan. (g) (1) For purposes of this section, a “risk-bearing organization” means a professional medical corporation, other form of corporation controlled by physicians and surgeons, a medical partnership, a medical foundation exempt from licensure pursuant to subdivision (l) of Section 1206, or another lawfully organized group of physicians that delivers, furnishes, or otherwise arranges for or provides health care services, but does not include an individual or a health care service plan, and that does all of the following: (A) Contracts directly with a health care service plan or arranges for health care services for the health care service plan’s enrollees. (B) Receives compensation for those services on any capitated or fixed periodic payment basis. (C) Is responsible for the processing and payment of claims made by providers for services rendered by those providers on behalf of a health care service plan that are covered under the capitation or fixed periodic payment made by the plan to the risk-bearing organization. Nothing in this subparagraph in any way limits, alters, or abrogates any responsibility of a health care service plan under existing law. (2) Notwithstanding paragraph (1), risk-bearing organizations shall not be deemed to include a provider organization that meets either of the following requirements: (A) The health care service plan files with the department consolidated financial statements that include the provider organization. (B) The health care service plan is the only health care service plan with which the provider organization contracts for arranging or providing health care services and, during the previous and current fiscal years, the provider organization’s maximum potential expenses for providing or arranging for health care services did not exceed 115 percent of its maximum potential revenue for providing or arranging for those services. (h) For purposes of this section, “claims” include, but are not limited to, contractual obligations to pay capitation or payments on a managed hospital payment basis. (Amended by Stats. 2009, Ch. 298, Sec. 6. (AB 1540) Effective January 1, 2010.)
  19. 1375.5.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    A contract between a risk-bearing organization and a health care service plan cannot require the organization to take financial risk for health care services unless that term was first negotiated and agreed, or the contract fits Section 1375.4.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1375.5. No contract between a risk-bearing organization and a health care service plan that is issued, amended, delivered, or renewed in this state on or after July 1, 2000, shall include any provision that requires the risk-bearing organization to be at financial risk for the provision of health care services, unless the provision has first been negotiated and agreed to between the health care service plan and the risk-bearing organization. This section shall not prevent a risk-bearing organization from accepting the financial risk pursuant to a contract that meets the requirements of Section 1375.4. (Amended by Stats. 2002, Ch. 798, Sec. 1. Effective January 1, 2003.)
  20. 1375.6.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    A contract between a risk-bearing organization and a health care service plan cannot include certain provider payment terms unless those terms were first negotiated and agreed to.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1375.6. No contract between a risk-bearing organization and a health care service plan that is issued, amended, delivered, or renewed in this state on or after July 1, 2000, shall include any provision that requires a provider to accept rates or methods of payment specified in contracts with health care service plan affiliates or nonaffiliates unless the provision has been first negotiated and agreed to between the health care service plan and the risk-bearing organization. (Added by Stats. 1999, Ch. 529, Sec. 5. Effective January 1, 2000.)
  21. 1375.61.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    Health care service plans may not use certain out-of-state actions or lawful mifepristone/medication-abortion-related conduct as the sole basis to terminate, not renew, or discriminate against a provider.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1375.61. (a) A contract between a health care service plan and a provider of health care services shall not contain any term that would result in termination or nonrenewal of the contract or otherwise penalize the provider, based solely on either of the following: (1) A civil judgment issued in another state, a criminal conviction in another state, or another disciplinary action in another state, if the judgment, conviction, or disciplinary action is based solely on the application of another state’s law that interferes with a person’s right to receive care that would be lawful if provided in this state. (2) The manufacture, transport, distribution, delivery, receipt, acquisition, sale, possession, furnishment, dispensation, repackaging, or storage of brand name or generic mifepristone or any drug used for medication abortion that is lawful under the laws of the state. (b) A health care service plan shall not discriminate, with respect to the provision of, or contracts for, professional services, against a licensed provider solely on the basis of either of the following: (1) A civil judgment issued in another state, a criminal conviction in another state, or another disciplinary action in another state if the judgment, conviction, or disciplinary action is based solely on the application of another state’s law that interferes with a person’s right to receive care that would be lawful if provided in this state. (2) The manufacture, transport, distribution, delivery, receipt, acquisition, sale, possession, furnishment, dispensation, repackaging, or storage of brand name or generic mifepristone or any drug used for medication abortion that is lawful under the laws of the state. (c) This section does not apply to a civil judgment, a criminal conviction, or a disciplinary action imposed in another state based upon conduct that would subject a provider to claim, charge, or action under the laws of this state. (Amended by Stats. 2025, Ch. 136, Sec. 16. (AB 260) Effective September 26, 2025.)
  22. 1375.7.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    This section limits what contract terms a health care plan may include with providers, especially around material changes, notices, patient loads, confidentiality, and dental-contract updates.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1375.7. (a) This section shall be known and may be cited as the Health Care Providers’ Bill of Rights. (b) No contract issued, amended, or renewed on or after January 1, 2003, between a plan and a health care provider for the provision of health care services to a plan enrollee or subscriber shall contain any of the following terms: (1) (A) Authority for the plan to change a material term of the contract, unless the change has first been negotiated and agreed to by the provider and the plan or the change is necessary to comply with state or federal law or regulations or any accreditation requirements of a private sector accreditation organization. If a change is made by amending a manual, policy, or procedure document referenced in the contract, the plan shall provide 45 business days’ notice to the provider, and the provider has the right to negotiate and agree to the change. If the plan and the provider cannot agree to the change to a manual, policy, or procedure document, the provider has the right to terminate the contract prior to the implementation of the change. In any event, the plan shall provide at least 45 business days’ notice of its intent to change a material term, unless a change in state or federal law or regulations or any accreditation requirements of a private sector accreditation organization requires a shorter timeframe for compliance. However, if the parties mutually agree, the 45-business day notice requirement may be waived. Nothing in this subparagraph limits the ability of the parties to mutually agree to the proposed change at any time after the provider has received notice of the proposed change. (B) If a contract between a provider and a plan provides benefits to enrollees or subscribers through a preferred provider arrangement, the contract may contain provisions permitting a material change to the contract by the plan if the plan provides at least 45 business days’ notice to the provider of the change and the provider has the right to terminate the contract prior to the implementation of the change. (C) If a contract between a noninstitutional provider and a plan provides benefits to enrollees or subscribers covered under the Medi-Cal or Healthy Families Program and compensates the provider on a fee-for-service basis, the contract may contain provisions permitting a material change to the contract by the plan, if the following requirements are met: (i) The plan gives the provider a minimum of 90 business days’ notice of its intent to change a material term of the contract. (ii) The plan clearly gives the provider the right to exercise his or her intent to negotiate and agree to the change within 30 business days of the provider’s receipt of the notice described in clause (i). (iii) The plan clearly gives the provider the right to terminate the contract within 90 business days from the date of the provider’s receipt of the notice described in clause (i) if the provider does not exercise the right to negotiate the change or no agreement is reached, as described in clause (ii). (iv) The material change becomes effective 90 business days from the date of the notice described in clause (i) if the provider does not exercise his or her right to negotiate the change, as described in clause (ii), or to terminate the contract, as described in clause (iii). (2) A provision that requires a health care provider to accept additional patients beyond the contracted number or in the absence of a number if, in the reasonable professional judgment of the provider, accepting additional patients would endanger patients’ access to, or continuity of, care. (3) A requirement to comply with quality improvement or utilization management programs or procedures of a plan, unless the requirement is fully disclosed to the health care provider at least 15 business days prior to the provider executing the contract. However, the plan may make a change to the quality improvement or utilization management programs or procedures at any time if the change is necessary to comply with state or federal law or regulations or any accreditation requirements of a private sector accreditation organization. A change to the quality improvement or utilization management programs or procedures shall be made pursuant to paragraph (1). (4) A provision that waives or conflicts with any provision of this chapter. A provision in the contract that allows the plan to provide professional liability or other coverage or to assume the cost of defending the provider in an action relating to professional liability or other action is not in conflict with, or in violation of, this chapter. (5) A requirement to permit access to patient information in violation of federal or state laws concerning the confidentiality of patient information. (c) With respect to a health care service plan contract covering dental services or a specialized health care service plan contract covering dental services, all of the following shall apply: (1) If a material change is made to the health care service plan’s rules, guidelines, policies, or procedures concerning dental provider contracting or coverage of or payment for dental services, the plan shall provide at least 45 business days’ written notice to the dentists contracting with the health care service plan to provide services under the plan’s individual or group plan contracts, including specialized health care service plan contracts, unless a change in state or federal law or regulations or any accreditation requirements of a private sector accreditation organization requires a shorter timeframe for compliance. For purposes of this paragraph, written notice shall include notice by electronic mail or facsimile transmission. This paragraph shall apply in addition to the other applicable requirements imposed under this section, except that it shall not apply where notice of the proposed change is required to be provided pursuant to subparagraph (C) of paragraph (1) of subdivision (b). (2) For purposes of paragraph (1), a material change made to a health care service plan’s rules, guidelines, policies, or procedures concerning dental provider contracting or coverage of or payment for dental services is a change to the system by which the plan adjudicates and pays claims for treatment that would reasonably be expected to cause delays or disruptions in processing claims or making eligibility determinations, or a change to the general coverage or general policies of the plan that affect rates and fees paid to providers. (3) A plan that automatically renews a contract with a dental provider shall annually make available to the provider, within 60 days following a request by the provider, either online, via email, or in paper form, a copy of its current contract and a summary of the changes described in paragraph (1) of subdivision (b) that have been made since the contract was issued or last renewed. (4) This subdivision shall not apply to a health care service plan that exclusively contracts with no more than two medical groups in the state to provide or arrange for the provision of professional medical services to the enrollees of the plan. (d) (1) When a contracting agent sells, leases, or transfers a health provider’s contract to a payor, the rights and obligations of the provider shall be governed by the underlying contract between the health care provider and the contracting agent. (2) For purposes of this subdivision, the following terms shall have the following meanings: (A) “Contracting agent” has the meaning set forth in paragraph (2) of subdivision (d) of Section 1395.6. (B) “Payor” has the meaning set forth in paragraph (3) of subdivision (d) of Section 1395.6. (e) Any contract provision that violates subdivision (b), (c), or (d) shall be void, unlawful, and unenforceable. (f) The department shall compile the information submitted by plans pursuant to subdivision (h) of Section 1367 into a report and submit the report to the Governor and the Legislature by March 15 of each calendar year. (g) Nothing in this section shall be construed or applied as setting the rate of payment to be included in contracts between plans and health care providers. (h) For purposes of this section the following definitions apply: (1) “Health care provider” means any professional person, medical group, independent practice association, organization, health care facility, or other person or institution licensed or authorized by the state to deliver or furnish health services. (2) “Material” means a provision in a contract to which a reasonable person would attach importance in determining the action to be taken upon the provision. (Amended by Stats. 2012, Ch. 447, Sec. 1. (AB 2252) Effective January 1, 2013.)
  23. 1375.8.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    Health care service plan contracts generally cannot make providers take financial risk for certain covered items, and those items must instead be reimbursed on a fee-for-service basis unless the provider makes a written request to assume the risk.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1375.8. (a) The Legislature finds the following: (1) Because of the nature and cost of certain medical items, the financial risk of these items is better retained by the health care service plan than by a health care service provider. (2) Allowing a health care service provider to take the financial risk for the items described in this section only if the provider specifically requests in writing to assume that risk, will assist in maintaining patient access to health care service providers. (b) (1) Notwithstanding Section 1375.5, no health care service plan contract that is issued, amended, delivered, or renewed in this state on or after July 1, 2003, shall require or allow a health care service provider to assume or be at any financial risk for any item described in subparagraphs (A) to (F), inclusive, of paragraph (2) when covered under the applicable plan contract and administered in the office of a physician and surgeon or prescribed by a physician and surgeon for self-administration by the patient. “Self-administration,” for the purposes of this section, means an injectable medication that can be safely given intramuscularly, or in the muscle, or subcutaneously, or under the skin, by the patient or his or her family member. (2) The items described in subparagraphs (A) to (F), inclusive, shall, instead, be reimbursed on a fee-for-service basis at the negotiated contract rate or through an alternate funding mechanism mutually agreed to by the health care service plan and the health care service provider, subject to any applicable copayment or deductible, by the health care service plan. (A) Injectable chemotherapeutic medications and injectable adjunct pharmaceutical therapies for side effects. (B) Injectable medications or blood products used for hemophilia. (C) Injectable medications related to transplant services. (D) Adult vaccines. (E) Self-injectable medications. (F) Other injectable medication or medication in an implantable dosage form costing more than two hundred fifty dollars ($250) per dose. (3) Notwithstanding the provisions of paragraphs (1) and (2), a health care service provider may assume financial risk for the items described in subparagraphs (A) to (F), inclusive, of paragraph (2) after making the request in writing at the time of negotiating an initial contract or renewing a contract with a health care service plan. No health care service plan may request or require that as a condition of the contract agreement a health care service provider shall request to assume the financial risk for any of those items. (c) The following definitions apply for the purposes of this section: (1) “Financial risk” means any contractual financial agreement between a health care service provider and a health care service plan for services rendered to a patient or enrollee if the reimbursement from a health care service plan is other than a fee for service rate structure. “Financial risk” includes, but is not limited to, capitation payments, case rates, and risk pools. (2) “Health care service provider” means an individual, partnership, group, or corporation lawfully licensed or organized under Division 2 (commencing with Section 500) of the Business and Professions Code, unless specifically exempt from those provisions, or licensed under Section 1204 or exempt from licensure under Section 1206 that delivers, furnishes, or otherwise arranges for or provides health care services. “Health care service provider” does not include a health facility as defined in Section 1250, a hospice, a surgical center, or a home infusion provider. (d) This section shall not preclude any payment by a health care service plan to a health care service provider for the performance of any services related to quality measures and programs. (e) This section shall not apply to a contract that is between a health care service plan and a health care service provider or a provider organization that meets either of the requirements set forth in paragraph (2) of subdivision (g) of Section 1375.4 or to a contract between licensed health care service plans or to a contract between a health care service plan and a health care service plan with waivers. (Added by Stats. 2002, Ch. 798, Sec. 2. Effective January 1, 2003.)
  24. 1375.9.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    A health care service plan must keep at least one full-time equivalent primary care physician for every 2,000 enrollees, with a limited increase allowed for each supervised nonphysician medical practitioner.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1375.9. (a) A health care service plan shall ensure that there is at least one full-time equivalent primary care physician for every 2,000 enrollees of the plan. The number of enrollees per primary care physician may be increased by up to 1,000 additional enrollees for each full-time equivalent nonphysician medical practitioner supervised by that primary care physician. (b) This section shall not require a primary care physician to accept an assignment of enrollees by a health care service plan without his or her approval, or that would be contrary to paragraph (2) of subdivision (b) of Section 1375.7. (c) This section does not modify subdivision (e) of Section 2836.1 of the Business and Professions Code or subdivision (b) of Section 3516 of the Business and Professions Code. (d) For purposes of this section, a primary care provider includes a “nonphysician medical practitioner,” which is defined as a physician assistant performing services under the supervision of a primary care physician in compliance with Chapter 7.7 (commencing with Section 3500) of Division 2 of the Business and Professions Code or a nurse practitioner performing services in collaboration with a physician pursuant to Chapter 6 (commencing with Section 2700) of Division 2 of the Business and Professions Code. (Amended by Stats. 2018, Ch. 152, Sec. 1. (SB 997) Effective January 1, 2019.)
  25. 1376.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    Plans, solicitor firms, and licensees must follow director-made rules on finances and fund handling; the director may also set capital, bond, and exemption requirements.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1376. (a) No plan shall conduct any activity regulated by this chapter in contravention of such rules and regulations as the director may prescribe as necessary or appropriate in the public interest or for the protection of plans, subscribers, and enrollees to provide safeguards with respect to the financial responsibility of plans. Such rules and regulations may require a minimum capital or net worth, limitations on indebtedness, procedures for the handling of funds or assets, including segregation of funds, assets and net worth, the maintenance of appropriate insurance and a fidelity bond and the maintenance of a surety bond in an amount not exceeding fifty thousand dollars ($50,000). (b) The surety bond referred to in subdivision (a) shall be conditioned upon compliance by the licensee with the provisions of this chapter and the rules and regulations adopted pursuant to this chapter and orders issued under this chapter. Every surety bond shall provide that no suit may be maintained to enforce any liability thereon unless brought within two years after the act upon which such suit is based. (c) For purposes of computing any minimum capital requirement which may be prescribed by the rules and regulations of the director under subdivision (a), any operating cost assistance or direct loan made to a plan by the United States Department of Health and Human Services pursuant to Public Law 93-222, as amended, may be treated as a subordinated loan, notwithstanding any express terms thereof to the contrary. (d) Each solicitor and solicitor firm shall handle funds received for the account of plans, subscribers, or groups in accordance with such rules as the director may adopt pursuant to this subdivision. (e) The director may, by regulation, designate requirements of this section or regulations adopted pursuant to this section, from which public entities and political subdivisions of the state shall be exempt. (Amended by Stats. 1999, Ch. 525, Sec. 123. Effective January 1, 2000. Operative July 1, 2000, or sooner, by Sec. 214 of Ch. 525.)
  26. 1376.1.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    Certain county- or city-and-county-operated health care service plans are exempt from the stated deposit requirements if they meet two financial conditions.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1376.1. The deposit requirements of Section 1300.76.1 of Title 28 of the California Code of Regulations shall not apply to any plan operated by a county, or city and county, if both of the following apply: (a) All of the evidence of indebtedness of the county, or city and county, has been rated “A” or better by Moody’s Investors Service, Inc. or Standard & Poor’s Corporation, based on a rating conducted during the immediately preceding 12 months. (b) The county, or city and county, has cash or cash equivalents in an amount equal to fifty million dollars ($50,000,000) or more, based on its audited financial statements for the immediately preceding fiscal year. For purposes of this subdivision, the term “equivalents” shall have the same meaning as in Section 1300.77 of Title 28 of the California Code of Regulations. (Amended by Stats. 2009, Ch. 298, Sec. 7. (AB 1540) Effective January 1, 2010.)
  27. 1377.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    Health care service plans above a 10% reimbursement threshold must follow deposit, insurance, reporting, and claim-handling rules, with the director overseeing approvals and possible waivers.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1377. (a) Every plan which reimburses providers of health care services that do not contract in writing with the plan to provide health care services, or which reimburses its subscribers or enrollees for costs incurred in having received health care services from providers that do not contract in writing with the plan, in an amount which exceeds 10 percent of its total costs for health care services for the immediately preceding six months, shall comply with the requirements set forth in either paragraph (1) or (2): (1) (A) Place with the director, or with any organization or trustee acceptable to the director through which a custodial or controlled account is maintained, a noncontracting provider insolvency deposit consisting of cash or securities that are acceptable to the director that at all times have a fair market value in an amount at least equal to 120 percent of the sum of the following: (i) All claims for noncontracting provider services received for reimbursement, but not yet processed. (ii) All claims for noncontracting provider services denied for reimbursement during the previous 45 days. (iii) All claims for noncontracting provider services approved for reimbursement, but not yet paid. (iv) An estimate of claims for noncontracting provider services incurred, but not reported. (B) Each plan licensed pursuant to this chapter prior to January 1, 1991, shall, upon that date, make a deposit of 50 percent of the amount required by subparagraph (A), and shall maintain additional cash or cash equivalents as defined by rule of the director, in the amount of 50 percent of the amount required by subparagraph (A), and shall make a deposit of 100 percent of the amount required by subparagraph (A) by January 1, 1992. (C) The amount of the deposit shall be reasonably estimated as of the first day of the month and maintained for the remainder of the month. (D) The deposit required by this paragraph is in addition to the deposit that may be required by rule of the director and is an allowable asset of the plan in the determination of tangible net equity as defined in subdivision (b) of Section 1300.76 of Title 28 of the California Code of Regulations. All income from the deposit shall be an asset of the plan and may be withdrawn by the plan at any time. (E) A health care service plan that has made a deposit may withdraw that deposit or any part of the deposit if (i) a substitute deposit of cash or securities of equal amount and value is made, (ii) the fair market value exceeds the amount of the required deposit, or (iii) the required deposit under this paragraph is reduced or eliminated. Deposits, substitutions, or withdrawals may be made only with the prior written approval of the director, but approval shall not be required for the withdrawal of earned income. (F) The deposit required under this section is in trust and may be used only as provided by this section. The director or, if a receiver has been appointed, the receiver shall use the deposit of an insolvent health care service plan, as defined in Sections 1394.7 and 1394.8, for payment of covered claims for services rendered by noncontracting providers under circumstances covered by the plan. All claims determined by the director or receiver, in his or her discretion, to be eligible for reimbursement under this section shall be paid on a pro rata basis based on assets available from the deposit to pay the ultimate liability for incurred expenditures. Partial distribution may be made pending final distribution. Any amount of the deposit remaining shall be paid into the liquidation or receivership of the health care service plan. The director may also use the deposit of an insolvent health care service plan for payment of any administrative costs associated with the administration of this section. The department, the director, and any employee of the department shall not be liable, as provided by Section 820.2 of the Government Code, for an injury resulting from an exercise of discretion pursuant to this section. Nothing in this section shall be construed to provide immunity for the acts of a receiver, except when the director is acting as a receiver. (G) The director may, by regulation, prescribe the time, manner, and form for filing claims. (H) The director may permit a plan to meet a portion of this requirement by a deposit of tangible assets acceptable to the director, the fair market value of which shall be determined on at least an annual basis by the director. The plan shall bear the cost of any appraisal or valuations required hereunder by the director. (2) Maintain adequate insurance, or a guaranty arrangement approved in writing by the director, to pay for any loss to providers, subscribers, or enrollees claiming reimbursement due to the insolvency of the plan. (b) Whenever the reimbursements described in this section exceed 10 percent of the plan’s total costs for health care services over the immediately preceding six months, the plan shall file a written report with the director containing the information necessary to determine compliance with subdivision (a) no later than 30 business days from the first day of the month. Upon an adequate showing by the plan that the requirements of this section should be waived or reduced, the director may waive or reduce these requirements to an amount as the director deems sufficient to protect subscribers and enrollees of the plan consistent with the intent and purpose of this chapter. (c) Every plan which reimburses providers of health care service on a fee-for-services basis; or which directly reimburses its subscribers or enrollees, to an extent exceeding 10 percent of its total payments for health care services, shall estimate and record in the books of account a liability for incurred and unreported claims. Upon a determination by the director that the estimate is inadequate, the director may require the plan to increase its estimate of incurred and unreported claims. Every plan shall promptly report to the director whenever these reimbursables exceed 10 percent of its total expenditures for health care services. As used herein, the term “fee-for-services” refers to the situation where the amount of reimbursement paid by the plan to providers of service is determined by the amount and type of service rendered by the provider of service. (d) In the event an insolvent plan covered by this section fails to pay a noncontracting provider sums for covered services owed, the provider shall first look to the uncovered expenditures insolvency deposit or the insurance or guaranty arrangement maintained by the plan for payment. When a plan becomes insolvent, in no event shall a noncontracting provider, or agent, trustee, or assignee thereof, attempt to collect from the subscriber or enrollee sums owed for covered services by the plan or maintain any action at law against a subscriber or enrollee to collect sums owed by the plan for covered services without having first attempted to obtain reimbursement from the plan. (Amended by Stats. 2009, Ch. 298, Sec. 8. (AB 1540) Effective January 1, 2010.)
  28. 1378.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    A health care service plan may not spend an excessive amount on administrative costs in a fiscal year from the dues, fees, and periodic payments it receives for providing health care services.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1378. No plan shall expend for administrative costs in any fiscal year an excessive amount of the aggregate dues, fees and other periodic payments received by the plan for providing health care services to its subscribers or enrollees. The term “administrative costs,” as used herein, includes costs incurred in connection with the solicitation of subscribers or enrollees for the plan. This section shall not preclude a plan from expending additional sums of money for administrative costs provided such money is not derived from revenue obtained from subscribers or enrollees of the plan. (Added by Stats. 1975, Ch. 941.)
  29. 1379.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    Health care service plan contracts with providers must be in writing and must include a term that protects the subscriber or enrollee from liability for plan-paid sums.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1379. (a) Every contract between a plan and a provider of health care services shall be in writing, and shall set forth that in the event the plan fails to pay for health care services as set forth in the subscriber contract, the subscriber or enrollee shall not be liable to the provider for any sums owed by the plan. (b) In the event that the contract has not been reduced to writing as required by this chapter or that the contract fails to contain the required prohibition, the contracting provider shall not collect or attempt to collect from the subscriber or enrollee sums owed by the plan. (c) No contracting provider, or agent, trustee or assignee thereof, may maintain any action at law against a subscriber or enrollee to collect sums owed by the plan. (Added by Stats. 1975, Ch. 941.)
  30. 1379.5.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    Certain health plan contracts must require providers in Mexico to report specified diseases or suspected diseases to the appropriate California health officer, and plans must give a written notice when the signed contract is delivered.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1379.5. (a) On and after July 1, 2008, every contract between a plan and a health care provider who provides health care services in Mexico to an enrollee of the plan shall require the health care provider knowing of, or in attendance on, a case or suspected case of any disease or condition listed in subdivision (j) of Section 2500 of Title 17 of the California Code of Regulations to report the case to the health officer of the jurisdiction in California where the patient in the case resides, or if the patient resides in Mexico and is employed in California, the contract shall require a health care provider to report the case to the health officer of the jurisdiction where the patient in the case is employed. The contract provision shall require the health care provider to make the report in accordance with subdivision (d) of Section 2500 of Title 17 of the California Code of Regulations, except that for reports in cases where the patient resides in Mexico the contract shall require the report to be made to the health officer of the jurisdiction where the patient is employed. (b) For purposes of this section, the terms “case,” “health care provider,” “health officer,” “in attendance,” and “suspected case” shall have the same meanings as set forth in subdivision (a) of Section 2500 of Title 17 of the California Code of Regulations. (c) A plan’s obligations under this section shall be limited to the following: (1) Ensuring that the contracts executed by providers who provide health care services in Mexico satisfy the requirements set forth in subdivision (a). (2) Giving the following written notice to the provider at the time the signed contract is delivered: “This contract contains specific requirements regarding reporting of actual or suspected diseases or conditions to California health officers.” (Added by Stats. 2007, Ch. 385, Sec. 1. Effective January 1, 2008.)
  31. 138.4.

    ## Health and Safety Code - HSC ## DIVISION 1. ADMINISTRATION OF PUBLIC HEALTH [135 - 1179.102] ( Division 1 enacted by Stats. 1939, Ch. 60. ) ## PART 1. STATE DEPARTMENT OF HEALTH SERVICES [137 - 429.997] ( Heading of Part 1 amended by Stats. 1980, Ch. 676. ) ## CHAPTER 1.3. Women’s Health [137 - 140] ( Chapter 1.3 added by Stats. 1994, Ch. 760, Sec. 2. )

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    The State Department of Public Health must prioritize providing information about women’s gynecological cancers and consult specified groups when exercising its powers. It may also adopt regulations to implement the section.

    ## Health and Safety Code - HSC ## DIVISION 1. ADMINISTRATION OF PUBLIC HEALTH [135 - 1179.102] ( Division 1 enacted by Stats. 1939, Ch. 60. ) ## PART 1. STATE DEPARTMENT OF HEALTH SERVICES [137 - 429.997] ( Heading of Part 1 amended by Stats. 1980, Ch. 676. ) ## CHAPTER 1.3. Women’s Health [137 - 140] ( Chapter 1.3 added by Stats. 1994, Ch. 760, Sec. 2. ) ## 138.4. (a) The State Department of Public Health shall place priority on providing information to consumers, patients, and health care providers regarding women’s gynecological cancers, including signs and symptoms, risk factors, the benefits of early detection through appropriate diagnostic testing, and treatment options. (b) In exercising the powers under this section, the State Department of Public Health shall consult with appropriate health care professionals and providers, consumers, and patients, or organizations representing them. (c) The duties of the State Department of Public Health pursuant to this section are contingent upon the receipt of funds appropriated for this purpose. (d) The State Department of Public Health may adopt any regulations necessary and appropriate for the implementation of this section. (Amended by Stats. 2012, Ch. 23, Sec. 10. (AB 1467) Effective June 27, 2012.)
  32. 138.6.

    ## Health and Safety Code - HSC ## DIVISION 1. ADMINISTRATION OF PUBLIC HEALTH [135 - 1179.102] ( Division 1 enacted by Stats. 1939, Ch. 60. ) ## PART 1. STATE DEPARTMENT OF HEALTH SERVICES [137 - 429.997] ( Heading of Part 1 amended by Stats. 1980, Ch. 676. ) ## CHAPTER 1.3. Women’s Health [137 - 140] ( Chapter 1.3 added by Stats. 1994, Ch. 760, Sec. 2. )

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    The State Department of Public Health must include certain breast cancer information in any literature it produces on the topic.

    ## Health and Safety Code - HSC ## DIVISION 1. ADMINISTRATION OF PUBLIC HEALTH [135 - 1179.102] ( Division 1 enacted by Stats. 1939, Ch. 60. ) ## PART 1. STATE DEPARTMENT OF HEALTH SERVICES [137 - 429.997] ( Heading of Part 1 amended by Stats. 1980, Ch. 676. ) ## CHAPTER 1.3. Women’s Health [137 - 140] ( Chapter 1.3 added by Stats. 1994, Ch. 760, Sec. 2. ) ## 138.6. (a) The State Department of Public Health shall include in any literature that it produces regarding breast cancer information that shall include, but not be limited to, all of the following: (1) Summarized information on risk factors for breast cancer in younger women, including, but not limited to, information on the increased risk associated with a family history of the disease. (2) Summarized information regarding detection alternatives to mammography that may be available and more effective for at-risk women between the ages of 25 and 40 years. (3) Information on Internet Web sites of relevant organizations, government agencies, and research institutions where information on mammography alternatives may be obtained. (b) The information required by subdivision (a) shall be produced consistent with the department’s protocols and procedures regarding the production and dissemination of information on breast cancer, including, but not limited to, the following factors: (1) Restrictions imposed by space limitation on materials currently produced and distributed by the department. (2) Future regular production and replacement schedules. (3) Translation standards governing the number of languages and literacy levels. (4) The nature, content, and purpose of the material into which this new information will be incorporated. (c) It is the intent of the Legislature that subdivisions (a) and (b) apply to information that is distributed by any branch of the department, including, but not limited to, the Cancer Detection Section and the Office of Health Equity. (Amended by Stats. 2012, Ch. 23, Sec. 11. (AB 1467) Effective June 27, 2012.)
  33. 1380.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    The department must conduct periodic onsite medical surveys of each plan, and the director must publicly report results, give notice of deficiencies, and oversee followup review and confidentiality rules.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1380. (a) The department shall conduct periodically an onsite medical survey of the health delivery system of each plan. The survey shall include a review of the procedures for obtaining health services, the procedures for regulating utilization, peer review mechanisms, internal procedures for ensuring quality of care, and the overall performance of the plan in providing health care benefits and meeting the health needs of the subscribers and enrollees. (b) The survey shall be conducted by a panel of qualified health professionals experienced in evaluating the delivery of prepaid health care. The department shall be authorized to contract with professional organizations or outside personnel to conduct medical surveys and these contracts shall be on a noncompetitive bid basis and shall be exempt from Chapter 2 (commencing with Section 10290) of Part 2 of Division 2 of the Public Contract Code. These organizations or personnel shall have demonstrated the ability to objectively evaluate the delivery of health care by plans or health maintenance organizations. (c) Surveys performed pursuant to this section shall be conducted as often as deemed necessary by the director to assure the protection of subscribers and enrollees, but not less frequently than once every three years. Nothing in this section shall be construed to require the survey team to visit each clinic, hospital office, or facility of the plan. To avoid duplication, the director shall employ, but is not bound by, the following: (1) For hospital-based health care service plans, to the extent necessary to satisfy the requirements of this section, the findings of inspections conducted pursuant to Section 1279. (2) For health care service plans contracting with the State Department of Health Services pursuant to the Waxman-Duffy Prepaid Health Plan Act, the findings of reviews conducted pursuant to Section 14456 of the Welfare and Institutions Code. (3) To the extent feasible, reviews of providers conducted by professional standards review organizations, and surveys and audits conducted by other governmental entities. (d) Nothing in this section shall be construed to require the medical survey team to review peer review proceedings and records conducted and compiled under Section 1370 or medical records. However, the director shall be authorized to require onsite review of these peer review proceedings and records or medical records where necessary to determine that quality health care is being delivered to subscribers and enrollees. Where medical record review is authorized, the survey team shall ensure that the confidentiality of physician-patient relationship is safeguarded in accordance with existing law and neither the survey team nor the director or the director’s staff may be compelled to disclose this information except in accordance with the physician-patient relationship. The director shall ensure that the confidentiality of the peer review proceedings and records is maintained. The disclosure of the peer review proceedings and records to the director or the medical survey team shall not alter the status of the proceedings or records as privileged and confidential communications pursuant to Sections 1370 and 1370.1. (e) The procedures and standards utilized by the survey team shall be made available to the plans before the conducting of medical surveys. (f) During the survey the members of the survey team shall examine the complaint files kept by the plan pursuant to Section 1368. The survey report issued pursuant to subdivision (i) shall include a discussion of the plan’s record for handling complaints. (g) During the survey the members of the survey team shall offer advice and assistance to the plan as deemed appropriate. (h) (1) Survey results shall be publicly reported by the director as quickly as possible but no later than 180 days following the completion of the survey unless the director determines, in the director’s discretion, that additional time is reasonably necessary to fully and fairly report the survey results. The director shall provide the plan with an overview of survey findings and notify the plan of deficiencies found by the survey team at least 90 days before the release of the public report. (2) Reports on all surveys, deficiencies, and correction plans shall be open to public inspection except that no surveys, deficiencies, or correction plans shall be made public unless the plan has had an opportunity to review the report and file a response within 45 days of the date that the department provided the report to the plan. After reviewing the plan’s response, the director shall issue a final report that excludes any survey information and legal findings and conclusions determined by the director to be in error, describes compliance efforts, identifies deficiencies that have been corrected by the plan by the time of the director’s receipt of the plan’s 45-day response, and describes remedial actions for deficiencies requiring longer periods to the remedy required by the director or proposed by the plan. (3) The final report shall not include a description of “acceptable” or of “compliance” for any uncorrected deficiency. (4) Upon making the final report available to the public, a single copy of a summary of the final report’s findings shall be made available free of charge by the department to members of the public, upon request. Additional copies of the summary may be provided at the department’s cost. The summary shall include a discussion of compliance efforts, corrected deficiencies, and proposed remedial actions. (5) If requested by the plan, the director shall append the plan’s response to the final report issued pursuant to paragraph (2), and shall append to the summary issued pursuant to paragraph (4) a brief statement provided by the plan summarizing its response to the report. The plan may modify its response or statement at any time and provide modified copies to the department for public distribution no later than 10 days from the date of notification from the department that the final report will be made available to the public. The plan may file an addendum to its response or statement at any time after the final report has been made available to the public. The addendum to the response or statement shall also be made available to the public. (6) Any information determined by the director to be confidential pursuant to statutes relating to the disclosure of records, including the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code), shall not be made public. (i) (1) The director shall give the plan a reasonable time to correct deficiencies. Failure on the part of the plan to comply to the director’s satisfaction shall constitute cause for disciplinary action against the plan. (2) No later than 18 months following release of the final report required by subdivision (h), the department shall conduct a followup review to determine and report on the status of the plan’s efforts to correct deficiencies. The department’s followup report shall identify any deficiencies reported pursuant to subdivision (h) that have not been corrected to the satisfaction of the director. (3) If requested by the plan, the director shall append the plan’s response to the followup report issued pursuant to paragraph (2). The plan may modify its response at any time and provide modified copies to the department for public distribution no later than 10 days from the date of notification from the department that the followup report will be made available to the public. The plan may file an addendum to its response at any time after the followup report has been made available to the public. The addendum to the response or statement shall also be made available to the public. (4) Nothing in this section shall prohibit the director from taking any action permitted or required under this chapter in response to the survey results before the followup review is initiated or completed, including, but not limited to, taking enforcement actions and opening further investigations. This subdivision is declaratory of and clarifies existing law with respect to the director’s enforcement authority. (j) The director shall provide to the plan and to the executive officer of the Board of Dental Examiners a copy of information relating to the quality of care of any licensed dental provider contained in any report described in subdivisions (h) and (i) that, in the judgment of the director, indicates clearly excessive treatment, incompetent treatment, grossly negligent treatment, repeated negligent acts, or unnecessary treatment. Any confidential information provided by the director shall not be made public pursuant to this subdivision. Notwithstanding any other provision of law, the disclosure of this information to the plan and to the executive officer shall not operate as a waiver of confidentiality. There shall be no liability on the part of, and no cause of action of any nature shall arise against, the State of California, the Department of Managed Health Care, the Director of the Department of Managed Health Care, the Board of Dental Examiners, or any officer, agent, employee, consultant, or contractor of the state or the department or the board for the release of any false or unauthorized information pursuant to this section, unless the release of that information is made with knowledge and malice. (k) Nothing in this section shall be construed as affecting the director’s authority pursuant to Article 7 (commencing with Section 1386) or Article 8 (commencing with Section 1390) of this chapter. (Amended by Stats. 2024, Ch. 760, Sec. 1. (AB 3221) Effective January 1, 2025.)
  34. 1380.1.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

    Verify source ↗

    The committee must recommend audit standards, the director must publish proposed regulations by January 1, 2002, the director may approve private accreditation organizations, audits must occur at least annually, and the single audit cannot block certain separate audits by health care service plans.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1380.1. (a) The Legislature finds and declares as follows: (1) Multiple medical quality audits of health care providers, as many as 25 for some physician offices, increase costs for health care providers and health plans, and thus ultimately increase costs for the purchaser and the consumer, and result in the direction of limited health care resources to administrative costs instead of to patient care. (2) Streamlining the multiple medical quality audits required by health care service plans and insurers is vital to increasing the resources directed to patient care. (3) Few legislative proposals affecting health care services have the potential of benefiting all of the affected parties, including health plans, health care providers, purchasers, and consumers, through a reduction in administrative costs but without negatively affecting patient care. (b) The Advisory Committee on Managed Care shall recommend to the director standards for a uniform medical quality audit system, which shall include a single periodic medical quality audit. The director shall publish proposed regulations in that regard on or before January 1, 2002. (c) In developing those standards, the Advisory Committee on Managed Care shall seek comment from a broad and balanced range of interested parties. (d) The recommendations shall include all of the following: (1) Standards that will serve as the basis of the single periodic medical quality audit necessary to meet the criteria of this section. (2) Standards that will not be covered by the single periodic medical quality audit and that may be audited directly by health care service plans. (3) A list of those private sector accreditation organizations, if any, that have or can develop systems comparable to the recommended system, and the capability and expertise to accredit, audit, or credential providers. (e) (1) The director may approve private sector accreditation organizations as qualified organizations to perform the single periodic medical quality audits. (2) Audits shall be conducted at least annually. (f) The single medical quality audit shall not prevent licensed health care service plans from developing performance criteria or conducting separate audits for governmental or regulatory purposes, purchasers, or to address consumer complaints and grievances, management changes, or plan initiatives to improve or monitor quality. (Repealed and added by Stats. 2000, Ch. 856, Sec. 2. Effective January 1, 2001.)
  35. 1380.2.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

    Verify source ↗

    Health care service plans or their delegates must use the latest CAQH credentialing form and follow CAQH credentialing processes, with limits on extra information requests.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1380.2. (a) (1) Notwithstanding any other law, except as provided in Section 1374.197, on and after January 1, 2028, a full service health care service plan or its delegate shall subscribe to and use the most recent version of the Council for Affordable Quality Healthcare (CAQH) credentialing form, and shall comply with the CAQH credentialing processes. (2) A full service health care service plan or its delegate shall only request additional information from a provider to clarify and confirm information that is provided on the CAQH credentialing form, including verification of information not specifically disclosed on the provider’s application. The provider shall respond to the request within 10 business days. A health care service plan or its delegate shall minimize the number of requests for additional information from providers. A provider shall submit their credentialing form and maintain their credentialing information in the CAQH database in a manner consistent with CAQH standards. (b) This section does not apply to contracts with the State Department of Health Care Services pursuant to Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing with Section 14200) of Part 3 of Division 9 of the Welfare and Institutions Code. (Added by Stats. 2025, Ch. 630, Sec. 2. (AB 1041) Effective January 1, 2026.)
  36. 1380.3.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

    Verify source ↗

    The department must coordinate certain surveys with the State Department of Health Care Services when possible, without delaying the surveys or failing to conduct them.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1380.3. The department shall coordinate the surveys conducted pursuant to Section 1380 with the State Department of Health Care Services, to the extent possible, in order to allow for simultaneous oversight of Medi-Cal managed care plans by both departments, provided that this coordination does not result in a delay of the surveys required under Section 1380 or in the failure of the department to conduct those surveys. (Repealed and added by Stats. 2014, Ch. 573, Sec. 4. (SB 964) Effective January 1, 2015.)
  37. 13800.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 1. General Provisions [13800 - 13806] ( Chapter 1 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    This part may be cited as the Fire Protection District Law of 1987 or the Bergeson Fire District Law.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 1. General Provisions [13800 - 13806] ( Chapter 1 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13800. This part shall be known and may be cited as the Fire Protection District Law of 1987 or as the Bergeson Fire District Law. (Amended by Stats. 1993, Ch. 1195, Sec. 20.5. Effective January 1, 1994.)
  38. 13801.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 1. General Provisions [13800 - 13806] ( Chapter 1 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    The Legislature states that local fire and emergency services are important and that this part is meant to give local officials broad authority and preserve local control.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 1. General Provisions [13800 - 13806] ( Chapter 1 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13801. The Legislature finds and declares that the local provision of fire protection services, rescue services, emergency medical services, hazardous material emergency response services, ambulance services, and other services relating to the protection of lives and property is critical to the public peace, health, and safety of the state. Among the ways that local communities have provided for those services has been the creation of fire protection districts. Local control over the types, levels, and availability of these services is a long-standing tradition in California which the Legislature intends to retain. Recognizing that the state’s communities have diverse needs and resources, it is the intent of the Legislature in enacting this part to provide a broad statutory authority for local officials. The Legislature encourages local communities and their officials to adapt the powers and procedures in this part to meet their own circumstances and responsibilities. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  39. 13802.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 1. General Provisions [13800 - 13806] ( Chapter 1 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    This section defines key terms used in this part of the Fire Protection District Law.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 1. General Provisions [13800 - 13806] ( Chapter 1 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13802. As used in this part: (a) “City” means any city whether general law or charter, including a city and county, and including any city the name of which includes the word “town.” (b) “Day” means a calendar day. (c) “District” means a fire protection district created pursuant to this part or created pursuant to any law which this part supersedes. (d) “District board,” means the board of directors of a district. (e) “Employee” means any personnel of a district, including any regular or call firefighter hired and paid on a full-time or part-time basis, or any volunteer firefighter. “Employee” also includes any person who assists in the provision of any authorized emergency duty or service at the request of a person who has been authorized by the district board to request this assistance from other persons. (f) “Principal county” means the county having all or the greater portion of the entire assessed value, as shown on the last equalized assessment roll of the county or counties, of all taxable property within a district. (g) “Zone” means a service zone formed pursuant to Chapter 10 (commencing with Section 13950). (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  40. 13803.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 1. General Provisions [13800 - 13806] ( Chapter 1 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    This section says the new part governs fire protection districts, keeps certain existing districts and service zones in existence, and carves out pending reorganizations filed under the old law.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 1. General Provisions [13800 - 13806] ( Chapter 1 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13803. (a) This part provides the authority for the organization and powers of fire protection districts. This part succeeds the Fire Protection District Law of 1961 and all of its statutory predecessors. Any fire protection district organized or reorganized pursuant to the Fire Protection District Law of 1961 or any of its statutory predecessors which was in existence on January 1, 1988, shall remain in existence as if it had been organized pursuant to this part, except that when the district board is a county board of supervisors the number and method of selection of its board of directors shall continue to be governed by the provisions of Chapter 4 (commencing with Section 13831) of the Fire Protection District Law of 1961 in effect on December 31, 1987, as if that chapter had not been repealed. Any special fire protection zone formed pursuant to Chapter 12 (commencing with Section 13991) of the Fire Protection District Law of 1961 or any of its statutory predecessors which was in existence on January 1, 1988, shall remain in existence as a service zone as if it has been formed pursuant to Chapter 10 (commencing with Section 13950). (b) This part does not apply to any reorganization which was filed pursuant to the Fire Protection District Law of 1961 and which is pending on January 1, 1988. Those pending reorganizations may be continued and completed under, and in accordance with, the Fire Protection District Law of 1961. The repeals, amendments, and additions made by the act enacting this part shall not apply to any of those pending reorganizations, and the laws existing prior to January 1, 1988, shall continue in full force and effect as applied to those pending reorganizations. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  41. 13804.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 1. General Provisions [13800 - 13806] ( Chapter 1 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    This section says the part is needed for public health, safety, and welfare, and must be interpreted broadly to carry out its purposes.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 1. General Provisions [13800 - 13806] ( Chapter 1 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13804. This part is necessary for the public health, safety, and welfare, and shall be liberally construed to effectuate its purposes. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  42. 13805.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 1. General Provisions [13800 - 13806] ( Chapter 1 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    If one provision of this part is invalid, the rest still applies if it can work without the invalid part.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 1. General Provisions [13800 - 13806] ( Chapter 1 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13805. If any provision of this part or the application of any provision of this part in any circumstance or to any person, city, county, district, the state, or any agency or subdivision of the state is held invalid, that invalidity shall not affect other provisions or applications of this part which can be given effect without the invalid provision or application of the invalid provision, and to this end the provisions of this part are severable. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  43. 13806.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 1. General Provisions [13800 - 13806] ( Chapter 1 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    Any challenge to the validity of a district’s organization or actions must be brought under Chapter 9 of the Code of Civil Procedure.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 1. General Provisions [13800 - 13806] ( Chapter 1 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13806. Any action to determine the validity of the organization or of any action of a district shall be brought pursuant to Chapter 9 (commencing with Section 860) of Title 10 of Part 2 of the Code of Civil Procedure. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  44. 1381.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

    Verify source ↗

    Certain health plan-related entities must let the director inspect specified records, provide electronic copies when possible, and keep records searchable and preserved when requested.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1381. (a) All records, books, and papers of a plan, management company, solicitor, solicitor firm, and any provider or subcontractor providing health care or other services to a plan, management company, solicitor, or solicitor firm shall be open to inspection, including through electronic means, by the director. (b) To the extent feasible, all records, books, and papers described in subdivision (a) shall be located in this state. In examining such records outside this state, the director shall consider the cost to the plan, consistent with the effectiveness of the director’s examination, and may upon reasonable notice require that such records, books, and papers, or a specified portion thereof, be made available for examination in this state, or that a true and accurate copy of those records, books, and papers, or a specified portion thereof, be furnished to the director. (c) Pursuant to a request by the director to inspect the records, books, and papers described in subdivision (a), the plan, management company, solicitor, or solicitor firm, and a provider or subcontractor providing health care or other services to a plan, management company, solicitor, or solicitor firm to which the request is made shall do both of the following: (1) Furnish in electronic media records, books, and papers that are possessed in electronic media. (2) Conduct a diligent review of the records, books, and papers and make every effort to furnish those responsive to the director’s request. (d) (1) To the greatest extent feasible, all records, books, and papers described in subdivision (a) and furnished pursuant to a request under this section shall be furnished in a format that is digitally searchable. (2) If requested by the department, records, books, and papers described in subdivision (a) shall be preserved until furnished. (e) In addition to the powers granted to the director pursuant to Section 11181 of the Government Code, in connection with an investigation or action authorized by Article 2 (commencing with Section 11180) of Chapter 2 of Part 1 of Division 3 of Title 2 of the Government Code, the director may do both of the following: (1) Inspect and copy records, books, and papers described in subdivision (a). (2) Seek relief from an administrative law proceeding if, in the director’s determination, a plan, management company, solicitor, or solicitor firm, and a provider or subcontractor providing health care or other services to a plan, management company, solicitor, or solicitor firm fails to fully or timely respond to a duly authorized request for production of records, books, and papers. (f) For purposes of this section, “records, books, and papers” includes records, books, and papers that are possessed in any medium, including electronic media. (Amended by Stats. 2024, Ch. 760, Sec. 2. (AB 3221) Effective January 1, 2025.)
  45. 13810.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 2. Area [13810 - 13812] ( Chapter 2 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    Any territory, whether incorporated or unincorporated and whether contiguous or noncontiguous, may be included in a district.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 2. Area [13810 - 13812] ( Chapter 2 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13810. Any territory, whether incorporated or unincorporated, whether contiguous or noncontiguous, may be included in a district. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  46. 13811.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 2. Area [13810 - 13812] ( Chapter 2 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A state responsibility area may be included in a district, except certain commercial forest lands, and notice must be mailed to the Director of Forestry and Fire Protection for hearings on proposals to include such areas.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 2. Area [13810 - 13812] ( Chapter 2 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13811. Territory which has been classified as a state responsibility area may be included in a district, except for commercial forest lands which are timbered lands declared to be in a state responsibility area. The executive officer of the local agency formation commission shall give mailed notice of the commission’s hearing on any proposal to include a state responsibility area in a district, whether by annexation or formation, to the Director of Forestry and Fire Protection. The commission may approve the proposal. Upon inclusion of a state responsibility area in a district, whether by formation or annexation, the state shall retain its responsibility for fire suppression and prevention on timbered, brush, and grass-covered lands. The district shall be responsible for fire suppression and prevention for structures in the area and may provide the same services in the state responsibility area as it provides in other areas of the district. (Amended by Stats. 1988, Ch. 465, Sec. 5. Effective August 22, 1988.)
  47. 13812.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 2. Area [13810 - 13812] ( Chapter 2 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    The Cortese-Knox-Hertzberg Local Government Reorganization Act of 2000 governs any change of organization or reorganization of a district.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 2. Area [13810 - 13812] ( Chapter 2 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13812. The Cortese-Knox-Hertzberg Local Government Reorganization Act of 2000 (Division 3 (commencing with Section 56000) of Title 5 of the Government Code) shall govern any change of organization or reorganization of a district. (Amended by Stats. 2003, Ch. 296, Sec. 23. Effective January 1, 2004.)
  48. 13815.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 1. Initiation [13815 - 13822] ( Article 1 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A new district may be formed under this chapter.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 1. Initiation [13815 - 13822] ( Article 1 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13815. A new district may be formed pursuant to this chapter. (Amended by Stats. 2001, Ch. 176, Sec. 38. Effective January 1, 2002.)
  49. 13816.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 1. Initiation [13815 - 13822] ( Article 1 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A petition to form a new district must include specified information and may be used to make the proposal.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 1. Initiation [13815 - 13822] ( Article 1 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13816. A proposal to form a new district may be made by petition which shall do all of the following: (a) State that the proposal is made pursuant to this article. (b) Set forth a description of the boundaries of the territory to be included in the district. (c) Set forth the methods by which the district will be financed. (d) State the reasons for forming the district. (e) Propose a name for the district. (f) Designate no more than three persons as chief petitioners, setting forth their names and mailing addresses. (g) State whether the formation is consistent with the sphere of influence of any affected city or affected district. (h) Specify the number of members of the initial board of directors and the method of their selection, as provided by Article 3 (commencing with Section 13834). (i) Request that proceedings be taken for the formation pursuant to this chapter. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  50. 13817.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 1. Initiation [13815 - 13822] ( Article 1 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    Chief petitioners must publish a notice of intention before circulating a petition to form the district, include a statement of reasons, publish it in the required newspapers, file it within five days after publication, and only then may the petition be circulated for signatures.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 1. Initiation [13815 - 13822] ( Article 1 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13817. (a) Before circulating any petition, the chief petitioners shall publish a notice of intention which shall include a written statement not to exceed 500 words in length, setting forth the reasons for forming the district. The notice shall be published pursuant to Section 6061 of the Government Code in one or more newspapers of general circulation within the territory proposed to be included in the district. If the territory proposed to be included in the district is located in more than one county, publication of the notice shall be made in at least one newspaper of general circulation in each of the counties. (b) The notice shall be signed by at least one, but not more than three, chief petitioners and shall be in substantially the following form: “Notice of Intent to Circulate Petition Notice is hereby given of the intention to circulate a petition proposing to form the ______ (name of the district). The reasons for the proposal are: ______.” (c) Within five days after the date of publication, the chief petitioners shall file with the executive officer of the local agency formation commission of the principal county a copy of the notice together with an affidavit made by a representative of the newspaper in which the notice was published certifying to the fact of publication. (d) After the filing required pursuant to subdivision (c), the petition may be circulated for signatures. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  51. 13818.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 1. Initiation [13815 - 13822] ( Article 1 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A petition must be signed by at least 25% of the registered voters living in the area to be included in the district.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 1. Initiation [13815 - 13822] ( Article 1 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13818. The petition shall be signed by not less than 25 percent of the registered voters residing in the area to be included in the district, as determined by the local agency formation commission pursuant to subdivision (f) of Section 56375 of the Government Code. Sections 100 and 104 of the Elections Code shall govern the signing of the petition and the format of the petition. (Amended by Stats. 2001, Ch. 176, Sec. 39. Effective January 1, 2002.)
  52. 13819.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 1. Initiation [13815 - 13822] ( Article 1 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A petition may be filed as one document or in separate counterparts, and the chief petitioner or petitioners must file it with the executive officer of the local agency formation commission of the principal county.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 1. Initiation [13815 - 13822] ( Article 1 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13819. A petition may consist of a single instrument or separate counterparts. The chief petitioner or petitioners shall file the petition, including all counterparts, with the executive officer of the local agency formation commission of the principal county. The executive officer shall not accept a petition for filing unless the signatures have been secured within six months of the date on which the first signature was obtained and the chief petitioner or petitioners submitted the petition to the executive officer for filing within 60 days after the last signature was obtained. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  53. 1382.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

    Verify source ↗

    The director must inspect health care service plans at least every five years, charge the plan for certain examination costs, and issue a final report after reviewing the plan’s response.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1382. (a) The director shall conduct an examination of the fiscal and administrative affairs of any health care service plan, and each person with whom the plan has made arrangements for administrative, management, or financial services, as often as deemed necessary to protect the interest of subscribers or enrollees, but not less frequently than once every five years. (b) The expense of conducting any additional or nonroutine examinations pursuant to this section, and the expense of conducting any additional or nonroutine medical surveys pursuant to Section 1380 shall be charged against the plan being examined or surveyed. The amount shall include the actual salaries or compensation paid to the persons making the examination or survey, the expenses incurred in the course thereof, and overhead costs in connection therewith as fixed by the director. In determining the cost of examinations or surveys, the director may use the estimated average hourly cost for all persons performing examinations or surveys of plans for the fiscal year. The amount charged shall be remitted by the plan to the director. If recovery of these costs cannot be made from the plan, these costs may be added to, but subject to the limitation of, the assessment provided for in subdivision (b) of Section 1356. (c) Reports of all examinations shall be open to public inspection, except that no examination shall be made public, unless the plan has had an opportunity to review the examination report and file a statement or response within 45 days of the date that the department provided the report to the plan. After reviewing the plan’s response, the director shall issue a final report that excludes any survey information, legal findings, or conclusions determined by the director to be in error, describes compliance efforts, identifies deficiencies that have been corrected by the plan on or before the time the director receives the plan’s response, and describes remedial actions for deficiencies requiring longer periods for the remedy required by the director or proposed by the plan. (d) If requested in writing by the plan, the director shall append the plan’s response to the final report issued pursuant to subdivision (c). The plan may modify its response or statement at any time and provide modified copies to the department for public distribution not later than 10 days from the date of notification from the department that the final report will be made available to the public. The addendum to the response or statement shall also be made available to the public. (e) Notwithstanding subdivision (c), any health care service plan that contracts with the State Department of Health Services to provide service to Medi-Cal beneficiaries pursuant to Chapter 8 (commencing with Section 14200) of Part 3 of Division 9 of the Welfare and Institutions Code may make a written request to the director to permit the State Department of Health Services to review its examination report. (f) Upon receipt of the written request described in subdivision (e), the director may, consistent with Section 7921.505 of the Government Code, permit the State Department of Health Services to review the plan’s examination report. (g) Nothing in this section shall be construed as affecting the director’s authority pursuant to Article 7 (commencing with Section 1386) or Article 8 (commencing with Section 1390). (Amended by Stats. 2021, Ch. 615, Sec. 227. (AB 474) Effective January 1, 2022. Operative January 1, 2023, pursuant to Sec. 463 of Stats. 2021, Ch. 615.)
  54. 13820.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 1. Initiation [13815 - 13822] ( Article 1 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    The executive officer must review a petition, certify whether it has enough signatures, notify chief petitioners if it is insufficient, and handle any supplemental petition on a short deadline.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 1. Initiation [13815 - 13822] ( Article 1 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13820. (a) Within 30 days after the date of filing a petition, the executive officer of the local agency formation commission shall cause the petition to be examined and shall prepare a certificate of sufficiency indicating whether the petition is signed by the requisite number of signers. (b) The executive officer shall cause the names of the signers on the petition to be compared with the voters’ register in the office of the county clerk or registrar of voters and ascertain (i) the number of registered voters in the territory to be included in the district, and (ii) the number of qualified signers appearing upon the petition. (c) If the certificate of the executive officer shows the petition to be insufficient, the executive officer shall immediately give notice by certified mail of the insufficiency to the chief petitioners. That mailed notice shall state in what amount the petition is insufficient. Within 15 days after the date of the notice of insufficiency, the chief petitioners may file with the executive officer a supplemental petition bearing additional signatures. (d) Within 10 days after the date of filing a supplemental petition, the executive officer shall examine the supplemental petition and certify in writing the results of his or her examination. (e) The executive officer shall sign and date a certificate of sufficiency. That certificate shall also state the minimum signature requirements for a sufficient petition and show the results of the executive officer’s examination. The executive officer shall mail a copy of the certificate of sufficiency to the chief petitioners. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  55. 13821.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 1. Initiation [13815 - 13822] ( Article 1 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A county or city legislative body may initiate formation of a new district by resolution, but it must hold a public hearing, let people comment, and have the clerk file a certified copy with the local agency formation commission officer.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 1. Initiation [13815 - 13822] ( Article 1 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13821. (a) A proposal to form a new district may also be made by the adoption of a resolution of application by the legislative body of any county or city which contains territory proposed to be included in the district. Except for the provisions regarding the signers and signatures, and the chief petitioners, a resolution of application shall contain all of the matters specified for a petition in Section 13816. Before submitting a resolution of application, the legislative body shall conduct a public hearing on the resolution. (b) Notice of the hearing shall be published pursuant to Section 6061 of the Government Code in one or more newspapers of general circulation within the county or city. (c) At the hearing, the legislative body shall give any person an opportunity to present his or her views on the resolution. (d) The clerk of the legislative body shall file a certified copy of the resolution of application with the executive officer of the local agency formation commission of the principal county. (Amended by Stats. 1995, Ch. 529, Sec. 16. Effective October 4, 1995.)
  56. 13822.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 1. Initiation [13815 - 13822] ( Article 1 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    After a sufficient petition or a resolution of application is filed, the local agency formation commission must proceed under the specified Government Code chapter.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 1. Initiation [13815 - 13822] ( Article 1 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13822. Once the chief petitioners have filed a sufficient petition or a legislative body has filed a resolution of application, the local agency formation commission shall proceed pursuant to Chapter 5 (commencing with Section 56825) of Part 3 of Division 3 of Title 5 of the Government Code. (Amended by Stats. 2016, Ch. 366, Sec. 20. (SB 974) Effective January 1, 2017.)
  57. 13823.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    If the local agency formation commission approves forming a district, the board of supervisors must call and notice an election, and the election must be held 113 to 150 days later.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13823. (a) If the local agency formation commission approves the formation of a district, with or without amendment, wholly, partially, or conditionally, the board of supervisors shall call and give notice of the election to be held in the proposed district. If the proposed district lies in more than one county, the board of supervisors shall call and give notice of the election to be held in the territory of the proposed district which lies in that county. (b) The election shall be held on the next regular election date not less than 113 nor more than 150 days after the date the board of supervisors calls and gives notice of the election. (c) Notice of the election shall be published pursuant to Section 6061 of the Government Code in a newspaper of general circulation circulated within the territory of the proposed district which lies in the county. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  58. 13823.5.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    If the local agency formation commission approves the district and the petition has at least 51% of registered voters’ signatures, the board of supervisors may skip an election and adopt the required resolution.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13823.5. After the local agency formation commission approves the formation of the district, notwithstanding Section 13823, if the board of supervisors finds that the petition filed with the executive officer of the local agency formation commission pursuant to Section 13819 has been signed by not less than 51 percent of the registered voters residing within the territory to be included within the proposed district, the board of supervisors may dispense with an election and adopt the resolution required pursuant to Section 13829. The initial members of the board of directors of the district shall be determined pursuant to Article 3 (commencing with Section 13834) of Chapter 3 of Part 3 of Division 12. (Added by Stats. 1990, Ch. 1558, Sec. 5.)
  59. 13824.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    After a district formation election is called, the board of supervisors must mail notice to the local agency formation commission’s executive officer within five days, and the executive officer must prepare an impartial analysis for the election officials.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13824. Within five days after the district formation election has been called, the board of supervisors which has called the election shall transmit by registered mail a written notification of the election call to the executive officer of the local agency formation commission of the principal county. The written notice shall include the name and a description of the proposed district and may be in the form of a certified copy of the resolution adopted by the board of supervisors calling the district formation election. The executive officer of the local agency formation commission shall submit an impartial analysis of the proposed district formation to the officials in charge of conducting the district formation election, pursuant to Section 56859 of the Government Code. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  60. 13825.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    Certain voters, petitioners, and officials may file written arguments for or against a proposed district formation, but the arguments cannot exceed 300 words.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13825. (a) The chief petitioners or the agency filing the resolution or any member or members of the board of supervisors authorized by the board, or any individual voter or bona fide association of citizens entitled to vote on the district formation proposition, or any combination of these voters and associations of citizens, may file a written argument for or a written argument against the proposed district formation. Arguments shall not exceed 300 words. Based on the time reasonably necessary to prepare and print the text of the proposition, analysis, arguments, and sample ballots and to permit the 10-day public examination period as provided in Section 9190 of the Elections Code for the particular election, the elections officials shall fix and determine a reasonable date prior to the election after which no arguments for or against the measure may be submitted for printing and distribution to the voters pursuant to Section 13826. Notice of the date fixed shall be published by the elections officials pursuant to Section 6061 of the Government Code. Arguments may be changed until and including the date fixed by the elections officials. (b) If more than one argument for or more than one argument against the proposed district formation is filed with the elections officials within the time prescribed, the elections officials shall select one of the arguments for printing and distribution to the voters. In selecting the arguments, the elections officials shall give preference and priority in the order named to the arguments of the following: (1) Chief petitioners, or the agency filing the resolution. (2) The board of supervisors, or any member or members of the board authorized by the board. (3) Individual voters, or bona fide associations of citizens or a combination of voters and associations. (Amended by Stats. 1994, Ch. 923, Sec. 129. Effective January 1, 1995.)
  61. 13826.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    Election officials must print and mail a ballot pamphlet to eligible voters for the district formation election, and it must include specified materials.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13826. The elections officials in charge of conducting the election shall cause a ballot pamphlet concerning the district formation proposition to be voted on to be printed and mailed to each voter entitled to vote on the district formation question. Section 9190 of the Elections Code shall apply to the materials required to be contained in the ballot pamphlet. The ballot pamphlet shall contain the following, in the order prescribed: (a) The complete text of the proposition. (b) The impartial analysis of the proposition, submitted by the executive officer of the local agency formation commission. (c) The argument for the proposed district formation. (d) The argument against the proposed district formation. The elections officials shall mail a ballot pamphlet to each voter entitled to vote in the district formation election at least 10 days prior to the date of the election. The ballot pamphlet is “official matter” within the meaning of Section 13303 of the Elections Code. (Amended by Stats. 1994, Ch. 923, Sec. 130. Effective January 1, 1995.)
  62. 13827.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    The notice of election must include specified information about the election and the proposed district.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13827. The notice of election shall contain all of the following: (a) The date of the election. (b) The name of the proposed district. (c) The purposes for which the district is to be formed. (d) A statement that the first directors will be elected at that election who will take office or will be appointed as the case may be, if the district is formed. (e) A description of the boundaries of the proposed district. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  63. 13828.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    The formation election, and any district board election, must be conducted under the Uniform District Election Law. If the vote does not reach a majority in favor of forming the district, the board of supervisors must terminate the proceedings.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13828. (a) The formation election and the election of members of the district board, if any, shall be held and conducted in accordance with the Uniform District Election Law, Part 4 (commencing with Section 10500) of Division 10 of the Elections Code. (b) If less than a majority of the votes cast at the election is in favor of forming the district, the board of supervisors shall declare the proceedings terminated. (Amended by Stats. 1994, Ch. 923, Sec. 131. Effective January 1, 1995.)
  64. 13829.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    If voters approve forming the district, the supervisors must declare it organized by resolution; if the district spans multiple counties, the principal county clerk must send certified copies of that resolution to the other county clerks.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13829. If the majority of the votes cast at the election is in favor of forming the district the board or boards of supervisors shall by resolution entered on its minutes declare the district duly organized under the Fire Protection District Law, giving the name of the district, and the purposes for which it is formed, and describing its boundaries. If the district lies in more than one county, the county clerk of the principal county shall transmit a certified copy of the resolution to the county clerk of each of the other counties in which the district lies. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  65. 1383.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

    Verify source ↗

    Certain health maintenance organization plans must give the department copies of their annual federal reports.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1383. Every plan that is a health maintenance organization qualified under Section 1310(d) of Title XIII of the federal Public Health Service Act, shall provide the department with a copy of the reports the plan files annually with the United States Department of Health, Education, and Welfare pursuant to Title XIII of the federal Public Health Service Act. (Repealed and added by Stats. 1979, Ch. 1083.)
  66. 1383.1.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

    Verify source ↗

    Health care service plans must file a written policy with the department by July 1, 1997, give enrollees notice about second medical opinions, and explain how those requests are reviewed.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1383.1. (a) On or before July 1, 1997, every health care service plan shall file with the department a written policy, which is not subject to approval or disapproval by the department, describing the manner in which the plan determines if a second medical opinion is medically necessary and appropriate. Notice of the policy and information regarding the manner in which an enrollee may receive a second medical opinion shall be provided to all enrollees in the plan’s evidence of coverage. The written policy shall describe the manner in which requests for a second medical opinion are reviewed by the plan. (b) This section shall not apply to any health care service plan contract authorized under Article 5.6 (commencing with Section 1374.60). (c) Nothing in this section shall require a health care service plan to cover services or provide benefits that are not otherwise covered under the terms and conditions of the plan contract, nor to provide services through providers who are not under contract with the plan. (Amended by Stats. 1998, Ch. 215, Sec. 2. Effective January 1, 1999.)
  67. 1383.15.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

    Verify source ↗

    Health care service plans must provide or authorize second opinions when requested, follow response timelines, give written denial reasons, and apply network and copayment rules.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1383.15. (a) When requested by an enrollee or participating health professional who is treating an enrollee, a health care service plan shall provide or authorize a second opinion by an appropriately qualified health care professional. Reasons for a second opinion to be provided or authorized shall include, but are not limited to, the following: (1) If the enrollee questions the reasonableness or necessity of recommended surgical procedures. (2) If the enrollee questions a diagnosis or plan of care for a condition that threatens loss of life, loss of limb, loss of bodily function, or substantial impairment, including, but not limited to, a serious chronic condition. (3) If the clinical indications are not clear or are complex and confusing, a diagnosis is in doubt due to conflicting test results, or the treating health professional is unable to diagnose the condition, and the enrollee requests an additional diagnosis. (4) If the treatment plan in progress is not improving the medical condition of the enrollee within an appropriate period of time given the diagnosis and plan of care, and the enrollee requests a second opinion regarding the diagnosis or continuance of the treatment. (5) If the enrollee has attempted to follow the plan of care or consulted with the initial provider concerning serious concerns about the diagnosis or plan of care. (b) For purposes of this section, an appropriately qualified health care professional is a primary care physician or specialist who is acting within his or her scope of practice and who possesses a clinical background, including training and expertise, related to the particular illness, disease, condition or conditions associated with the request for a second opinion. For purposes of a specialized health care service plan, an appropriately qualified health care professional is a licensed health care provider who is acting within his or her scope of practice and who possesses a clinical background, including training and expertise, related to the particular illness, disease, condition or conditions associated with the request for a second opinion. (c) If an enrollee or participating health professional who is treating an enrollee requests a second opinion pursuant to this section, an authorization or denial shall be provided in an expeditious manner. When the enrollee’s condition is such that the enrollee faces an imminent and serious threat to his or her health, including, but not limited to, the potential loss of life, limb, or other major bodily function, or lack of timeliness that would be detrimental to the enrollee’s ability to regain maximum function, the second opinion shall be authorized or denied in a timely fashion appropriate for the nature of the enrollee’s condition, not to exceed 72 hours after the plan’s receipt of the request, whenever possible. Each plan shall file with the Department of Managed Health Care timelines for responding to requests for second opinions for cases involving emergency needs, urgent care, and other requests by July 1, 2000, and within 30 days of any amendment to the timelines. The timelines shall be made available to the public upon request. (d) If a health care service plan approves a request by an enrollee for a second opinion, the enrollee shall be responsible only for the costs of applicable copayments that the plan requires for similar referrals. (e) If the enrollee is requesting a second opinion about care from his or her primary care physician, the second opinion shall be provided by an appropriately qualified health care professional of the enrollee’s choice within the same physician organization. (f) If the enrollee is requesting a second opinion about care from a specialist, the second opinion shall be provided by any provider of the enrollee’s choice from any independent practice association or medical group within the network of the same or equivalent specialty. If the specialist is not within the same physician organization, the plan shall incur the cost or negotiate the fee arrangements of that second opinion, beyond the applicable copayments which shall be paid by the enrollee. If not authorized by the plan, additional medical opinions not within the original physician organization shall be the responsibility of the enrollee. (g) If there is no participating plan provider within the network who meets the standard specified in subdivision (b), then the plan shall authorize a second opinion by an appropriately qualified health professional outside of the plan’s provider network. In approving a second opinion either inside or outside of the plan’s provider network, the plan shall take into account the ability of the enrollee to travel to the provider. (h) The health care service plan shall require the second opinion health professional to provide the enrollee and the initial health professional with a consultation report, including any recommended procedures or tests that the second opinion health professional believes appropriate. Nothing in this section shall be construed to prevent the plan from authorizing, based on its independent determination, additional medical opinions concerning the medical condition of an enrollee. (i) If the health care service plan denies a request by an enrollee for a second opinion, it shall notify the enrollee in writing of the reasons for the denial and shall inform the enrollee of the right to file a grievance with the plan. The notice shall comply with subdivision (b) of Section 1368.02. (j) Unless authorized by the plan, in order for services to be covered the enrollee shall obtain services only from a provider who is participating in, or under contract with, the plan pursuant to the specific contract under which the enrollee is entitled to health care services. The plan may limit referrals to its network of providers if there is a participating plan provider who meets the standard specified in subdivision (b). (k) This section shall not apply to health care service plan contracts that provide benefits to enrollees through preferred provider contracting arrangements if, subject to all other terms and conditions of the contract that apply generally to all other benefits, access to and coverage for second opinions are not limited. (Amended by Stats. 2001, Ch. 328, Sec. 3. Effective January 1, 2002.)
  68. 13830.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    If a district lies in one county, the county clerk must have a certified copy of the resolution forming the district recorded with the county recorder after the resolution is entered in the board minutes.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13830. If the district lies in one county, immediately after entering the resolution in the board minutes pursuant to Section 13829, the county clerk shall cause to be recorded in the office of the county recorder of the county for which he or she is county clerk a certified copy of the resolution forming the district. Thereupon, the organization of the district shall be complete. (Amended by Stats. 1998, Ch. 829, Sec. 39. Effective January 1, 1999.)
  69. 13831.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    Informalities in district formation or elections do not invalidate a district if they do not substantially affect legal rights, and challenges to the district’s formation and organization must be brought within 60 days after formation is complete.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 2. Election [13823 - 13831] ( Article 2 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13831. (a) No informality in any proceeding, including informality in the conduct of any election not substantially affecting adversely the legal rights of any person, shall invalidate the formation of any district. (b) The validity of the formation and organization of a district shall not be contested in any proceeding commenced more than 60 days after the date that the formation of the district is complete. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  70. 13834.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 3. Selection of the Initial Board of Directors [13834 - 13839] ( Article 3 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    For districts formed on or after January 1, 1988, the initial board of directors must be determined under this article.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 3. Selection of the Initial Board of Directors [13834 - 13839] ( Article 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13834. The initial board of directors of a district formed on or after January 1, 1988, shall be determined pursuant to this article. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  71. 13835.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 3. Selection of the Initial Board of Directors [13834 - 13839] ( Article 3 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    If the district is in only unincorporated territory in one county, the district board may be elected or appointed by the county board of supervisors.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 3. Selection of the Initial Board of Directors [13834 - 13839] ( Article 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13835. In the case of a district which contains only unincorporated territory in a single county, the district board may be elected or may be appointed by the county board of supervisors which may appoint itself as the district board. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  72. 13836.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 3. Selection of the Initial Board of Directors [13834 - 13839] ( Article 3 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    For a district spanning only unincorporated territory in more than one county, the district board may be elected or appointed by county boards of supervisors.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 3. Selection of the Initial Board of Directors [13834 - 13839] ( Article 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13836. In the case of a district which contains only unincorporated territory in more than one county, the district board may be elected or may be appointed by the boards of supervisors of the counties in which the district is located. If the district board is appointed by the boards of supervisors, they shall appoint directors according to the proportionate share of population of that portion of each county within the district, provided that each board of supervisors shall appoint at least one director. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  73. 13837.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 3. Selection of the Initial Board of Directors [13834 - 13839] ( Article 3 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    For a district with unincorporated territory and one or more cities, the district board may be elected or appointed, and if appointed there are rules for how directors are allocated and who may serve.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 3. Selection of the Initial Board of Directors [13834 - 13839] ( Article 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13837. In the case of a district which contains unincorporated territory and the territory of one or more cities: (a) The district board may be elected or appointed by the county board of supervisors and the city councils in which the district is located. If the district board is to be appointed, the board of supervisors and the city council or councils shall appoint directors according to the proportionate share of population that portion of the county and each city within the district, provided that the board of superviors and each city council shall appoint at least one director. The board of supervisors or city council may appoint one or more of its own members to the district board. In no case shall the number of directors exceed 11 members. (b) Notwithstanding subdivision (a), the county board of supervisors may appoint itself as the district board, if the city council of each of the cities consents by resolution. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  74. 13838.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 3. Selection of the Initial Board of Directors [13834 - 13839] ( Article 3 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    If a district covers only incorporated territory within one city, the district board may be elected or appointed by the city council, and the council may appoint itself as the board.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 3. Selection of the Initial Board of Directors [13834 - 13839] ( Article 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13838. In the case of a district which includes only incorporated territory within a single city, the district board may be elected or appointed by the city council which may appoint itself as the district board. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  75. 13839.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 3. Selection of the Initial Board of Directors [13834 - 13839] ( Article 3 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    For a district made up only of incorporated territory in more than one city, city councils may elect or appoint the district board, and if they appoint it they must allocate directors by population share with at least one director from each city.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 3. Formation [13815 - 13839] ( Chapter 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## ARTICLE 3. Selection of the Initial Board of Directors [13834 - 13839] ( Article 3 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13839. In the case of a district which includes only incorporated territory in more than one city, the district board may be elected or appointed by the city councils in which the district is located. If the district board is appointed, the city councils shall appoint directors according to the proportionate share of population of that portion of each city within the district, provided that each city council shall appoint at least one director. The city council may appoint one or more of its own members to the district board. In no case shall the directors exceed the number permitted pursuant to Section 13842. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  76. 1384.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

    Verify source ↗

    Plans and certain related persons must file audit-related financial reports with the director on set deadlines, and the director can require extra reports, set formats, reject filings, and waive or extend some deadlines for good cause.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1384. (a) Within 90 days after receipt of a request from the director, a plan or other person subject to this chapter shall submit to the director an audit report containing audited financial statements covering the 12-calendar months next preceding the month of receipt of the request, or another period as the director may require. (b) On or before 105 days after the date of a notice of surrender or order of revocation, a plan shall file with the director a closing audit report containing audited financial statements. The reporting period for the closing audit report shall be the 12-month period preceding the date of the notice of surrender or order of revocation, or for another period as the director may specify. This report shall include other relevant information as specified by rule of the director. The director shall not consent to a surrender and an order of revocation shall not be considered final until the closing audit report has been filed with the director and all concerns raised by the director therefrom have been resolved by the plan, as determined by the director. For good cause, the director may waive the requirement of a closing audit report. (c) Except as otherwise provided in this subdivision, each plan shall submit financial statements prepared as of the close of its fiscal year within 120 days after the close of the fiscal year. The financial statements referred to in this subdivision and in subdivisions (a) and (b) of this section shall be accompanied by a report, certificate, or opinion of an independent certified public accountant or independent public accountant. The audits shall be conducted in accordance with generally accepted auditing standards and the rules and regulations of the director. However, financial statements from public entities or political subdivisions of the state whose audits are conducted by a county grand jury shall be submitted within 180 days after the close of the fiscal year and need not include a report, certificate, or opinion by an independent certified public accountant or an independent public accountant, and the audit shall be conducted in accordance with governmental auditing standards. (d) A plan, solicitor, or solicitor firm shall make any special reports to the director as the director may from time to time require. (e) For good cause and upon written request, the director may extend the time for compliance with subdivisions (a), (b), and (h) of this section. (f) A plan, solicitor, or solicitor firm shall, when requested by the director, for good cause, submit its unaudited financial statement, prepared in accordance with generally accepted accounting principles and consisting of at least a balance sheet and statement of income as of the date and for the period specified by the director. The director may require the submission of these reports on a monthly or other periodic basis. (g) If the report, certificate, or opinion of the independent accountant referred to in subdivision (c) is in any way qualified, the director may require the plan to take any action as the director deems appropriate to permit an independent accountant to remove the qualification from the report, certificate, or opinion. (h) The director may reject any financial statement, report, certificate, or opinion filed pursuant to this section by notifying the plan, solicitor, or solicitor firm required to make this filing of its rejection and the cause thereof. Within 30 days after the receipt of the notice, the person shall correct the deficiency, and the failure so to do shall be deemed a violation of this chapter. The director shall retain a copy of all filings so rejected. (i) The director may make rules and regulations specifying the form and content of the reports and financial statements referred to in this section, and may require that these reports and financial statements be verified by the plan or other person subject to this chapter in a manner as the director may prescribe. (Amended by Stats. 1999, Ch. 525, Sec. 130. Effective January 1, 2000. Operative July 1, 2000, or sooner, by Sec. 214 of Ch. 525.)
  77. 13840.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    Every district must be governed by a board of directors.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13840. Every district shall be governed by a legislative body known as a board of directors. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  78. 13841.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    District board members and certain fire commission members must live in the district, with an exception when a county board of supervisors has appointed itself as the district board.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13841. Except in the case where a county board of supervisors has appointed itself as the district board, each member of a district board and each member of a fire commission appointed pursuant to Section 13844 shall be a resident of the district. In addition, if the district board is elected, each member of the district board shall be a registered voter of the district. In the case of a district board which is elected by divisions, each director shall be a registered voter of the division from which he or she is elected. (Amended by Stats. 1990, Ch. 1558, Sec. 6.)
  79. 13842.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A district board may have 3, 5, 7, 9, or 11 members, unless a county board of supervisors or a city council has appointed itself as the district board.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13842. Except in the case where a county board of supervisors or a city council has appointed itself as the district board, a district board may have three, five, seven, nine, or eleven members. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  80. 13843.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A district board member generally serves a four-year term, unless a successor qualifies sooner; for districts formed on or after January 1, 1988, director terms follow the Uniform District Election Law.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13843. (a) The term of office of each member of a district board is four years or until his or her successor qualifies and takes office, except as provided in subdivision (b). (b) In the case of a district formed on or after January 1, 1988, the directors shall serve terms as provided in the Uniform District Election Law, Part 4 (commencing with Section 10500) of Division 10 of the Elections Code. (Amended by Stats. 1994, Ch. 923, Sec. 132. Effective January 1, 1995.)
  81. 13844.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    If a county board of supervisors or city council is acting as the district board, it may delegate its powers to a five- or seven-member fire commission, and it must decide whether commissioners serve at will or in staggered four-year terms.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13844. If a county board of supervisors or a city council has appointed itself as the district board, the board of supervisors or city council may delegate any or all of its powers to a fire commission composed of five or seven commissioners. In the case of a district governed by a board of supervisors, the commissioners may be councilmembers of cities which are located in the district. The board of supervisors or city council shall determine whether the commissioners shall serve at its pleasure or for staggered terms of four years subject to removal for cause. (Amended by Stats. 1989, Ch. 45, Sec. 1. Effective June 15, 1989.)
  82. 13845.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    The district board may place a question on the ballot to increase or decrease the number of board members, and must do so if it receives a petition signed by at least 25% of registered district voters.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13845. (a) Except in the case where a county board of supervisors or a city council has appointed itself as the district board, the number of members of a district board may be increased or decreased if a majority of the voters voting on the question are in favor of the question at a general district or special election. The question shall specify the resulting number of members of the district board. (b) The district board may adopt a resolution placing the question on the ballot. Alternatively, upon receipt of a petition signed by at least 25 percent of the registered voters of the district, the district board shall adopt a resolution placing the question on the ballot. (c) If the question is submitted to the voters at a general district election, the notice required by Section 12112 of the Elections Code shall contain a statement of the question to appear on the ballot. If the question is submitted to the voters at a special election, the notice of election and the ballot shall contain a statement of the question. (d) If the voters approve of increasing the number of directors, the new members shall be elected or appointed pursuant to this chapter. If the district board is elected, the additional members may be elected at the same election. (e) If the voters approve of decreasing the number of directors, the members of the district board continue to serve until the end of their current terms. (f) The number of members of a district board may be changed by the local agency formation commission as a term and condition of approval by the commission of any change of organization or reorganization. Unless the Cortese-Knox-Hertzberg Local Government Reorganization Act of 2000, Division 3 (commencing with Section 56000) of Title 5 of the Government Code, otherwise requires voter approval, the change ordered by the commission does not require approval by the voters of the district. (Amended by Stats. 2006, Ch. 588, Sec. 12. Effective January 1, 2007.)
  83. 13846.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    This section lets voters decide whether district directors are elected by divisions or at large, and sets out the board’s steps if the vote changes the election method.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13846. (a) In the case of an elected district board, the directors may be elected by divisions if a majority of the voters voting upon the question are in favor of the question at a general district or special election. Conversely, in the case of a district that has an elected district board which is elected by election division, the directors may be elected at large if a majority of the voters voting upon the question are in favor of the question at a general district or special election. (b) As used in this section, “election by division” means the election of each member of the district board by voters of only the respective election division. (c) The district board may adopt a resolution placing the question on the ballot. Alternatively, upon receipt of a petition signed by at least 25 percent of the registered voters of the district, the district board shall adopt a resolution placing the question on the ballot. (d) If the question is submitted to the voters at a general district election, the notice required by Section 12112 of the Elections Code shall contain a statement of the question to appear on the ballot. If the question is submitted to the voters at a special election, the notice of election and ballot shall contain a statement of the question. (e) If the majority of voters voting upon the question approves the election of directors by divisions, the district board shall promptly adopt a resolution dividing the district into as many divisions as there are directors. The resolution shall assign a number to each division. Using the last decennial census as a basis, the divisions shall be as nearly equal in population as possible. In establishing the boundaries of the divisions the district board may give consideration to the following factors: (1) topography, (2) geography, (3) cohesiveness, contiguity, integrity, and compactness of territory, and (4) community of interests of the divisions. (f) If the majority of voters voting upon the question approves the election of directors by division, the board members shall be elected by election divisions and each member elected shall be a resident of the election division from which he or she is elected. At the district general election following the approval by the voters of the election of directors by divisions, the district board shall assign vacancies on the board created by the expiration of terms to the respective election divisions and the vacancies shall be filled from those election divisions. (g) If the majority of voters voting upon the question approves the election of directors at large, the district board shall promptly adopt a resolution dissolving the election divisions which had existed. (Amended by Stats. 2006, Ch. 588, Sec. 13. Effective January 1, 2007.)
  84. 13847.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A district board elected by election divisions must update division boundaries after each decennial census and, in certain population-change situations, reexamine and readjust them promptly.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13847. In the case of a district board elected by election divisions, the district board shall adjust the boundaries of the election divisions before November 1 of the year following the year in which each decennial federal census is taken. If at any time between each decennial federal census a change of organization alters the population of the district or the district increases or decreases the number of members of the district board, the district board shall reexamine the boundaries of its election divisions. If the district board finds that the population of any election division has varied so that the divisions no longer meet the criteria specified in subdivision (d) of Section 13846, the district board shall adjust the boundaries of the election divisions so that the divisions shall be as nearly equal in population as possible. The district board shall make this change within 60 days of the effective date of the change of organization or an increase or decrease in the number of members of the district board. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  85. 13848.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    This section lets a fire protection district change between an appointed and an elected board if voters approve the question.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13848. (a) If a majority of the voters voting upon the question at a general district or special election are in favor, a district that has an appointed district board shall have an elected district board or a district that has an elected district board shall have an appointed district board. (b) The district board may adopt a resolution placing the question on the ballot. Alternatively, upon receipt of a petition signed by at least 25 percent of the registered voters of the district, the district board shall adopt a resolution placing the question on the ballot. (c) If the question is submitted to the voters at a general district election, the notice required by Section 12112 of the Elections Code shall contain a statement of the question to appear on the ballot. If the question is submitted to the voters at a special election, the notice of election and ballot shall contain a statement of the question. (d) If a majority of voters voting upon the question approves of changing from an appointed district board to an elected district board, the members of the district board shall be elected at the next general district election. If a majority of voters voting upon the question approves of changing from an elected district board to an appointed district board, members shall be appointed to the district board as vacancies occur. (Amended by Stats. 2006, Ch. 588, Sec. 14. Effective January 1, 2007.)
  86. 13849.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    Before circulating certain petitions, chief petitioners must publish a notice of intention, include a short written statement, and then file proof of publication within five days.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13849. (a) Before circulating any petition pursuant to Section 13845, 13846, or 13848 the chief petitioners shall publish a notice of intention which shall include a written statement not to exceed 500 words in length, setting forth the reasons for the proposal. The notice shall be published pursuant to Section 6061 of the Government Code in one or more newspapers of general circulation within the district. If the district is located in more than one county, publication of the notice shall be made in at least one newspaper of general circulation in each of the counties. (b) The notice shall be signed by at least one, but not more than three, chief petitioners and shall be in substantially the following form: “Notice of Intent to Circulate Petition Notice is hereby given of the intention to circulate a petition affecting the Board of Directors of the ______ (name of the district). The petition proposes that ______ (description of the proposal).” (c) Within five days after the date of publication, the chief petitioners shall file with the secretary of the district board a copy of the notice together with an affidavit made by a representative of the newspaper in which the notice was published certifying to the fact of publication. (d) After the filing required pursuant to subdivision (c), the petition may be circulated for signatures. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  87. 1385.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. )

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    Plans, solicitor firms, and solicitors must keep current books and records that the director requires by rule. Plans must also require contracted providers to report surcharge and copayment amounts in writing, unless the director approves otherwise.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6. Operation and Renewal Requirements and Procedures [1375.1 - 1385] ( Article 6 added by Stats. 1975, Ch. 941. ) ## 1385. Each plan, solicitor firm, and solicitor shall keep and maintain current such books of account and other records as the director may by rule require for the purposes of this chapter. Every plan shall require all providers who contract with the plan to report to the plan in writing all surcharge and copayment moneys paid by subscribers and enrollees directly to such providers, unless the director expressly approves otherwise. (Amended by Stats. 1999, Ch. 525, Sec. 131. Effective January 1, 2000. Operative July 1, 2000, or sooner, by Sec. 214 of Ch. 525.)
  88. 1385.001.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    This section defines several terms used in the Pharmacy Benefit Managers article, including “pharmacy benefit manager,” “rebates,” “spread pricing,” “department,” and “director.”

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.001. For the purposes of this article: (a) “Affiliated entity” means any of the following: (1) An applicable group purchasing organization, drug manufacturer, distributor, wholesaler, rebate aggregator or other purchasing entity designed to aggregate rebates, or associated third party. (2) A subsidiary, parent, affiliate, or subcontractor of a health care service plan or health insurer, an entity that provides pharmacy benefit management services on behalf of a health care service plan or health insurer, or an entity described in paragraph (1). (3) Any other entity as designated by the department. (b) “Affiliated pharmacy” means a contract pharmacy that directly, or indirectly through one or more intermediaries, controls, is controlled by, or is under common control with a pharmacy benefit manager. (c) “Claim” means a request for payment for administering, filling, or refilling a drug or for providing a pharmacy service or a medical supply or device to an enrollee or insured. (d) “Contract pharmacy” means a pharmacy that contracts directly or through a pharmacy services administration organization with a pharmacy benefit manager. (e) “Department” means the Department of Managed Health Care. (f) “Director” means the Director of the Department of Managed Health Care. (g) “Drug” has the same meaning as defined in Section 4025 of the Business and Professions Code. (h) “Group purchasing organization” means a third party or affiliated person, including an out-of-state or international organization, employed by, contracted with, affiliated with, under common ownership or control by, or otherwise utilized by an entity that provides pharmacy benefit management services or by a pharmacy benefit manager to negotiate, obtain, or otherwise procure rebates from drug manufacturers or wholesalers. (i) “Health insurer” means an entity licensed to provide health insurance, as defined in Section 106 of the Insurance Code. (j) “Manufacturer” has the same meaning as defined in Section 4033 of the Business and Professions Code. (k) “Nonaffiliated pharmacy” means a contract pharmacy that directly, or indirectly through one or more intermediaries, does not control, is not controlled by, and is not under common control with a pharmacy benefit manager. (l) “Passthrough pricing model” means a payment model used by a pharmacy benefit manager in which the payments made by the health care service plan or health insurer client to the pharmacy benefit manager for the covered outpatient drugs are both of the following: (1) Equivalent to the payments the pharmacy benefit manager makes to a pharmacy or provider for those drugs, including any contracted professional dispensing fee between the pharmacy benefit manager and its network of pharmacies. That dispensing fee would be paid if the health care service plan or health insurer was making the payments directly. (2) Passed through in their entirety by the health care service plan or health insurer client or by the pharmacy benefit manager to the pharmacy or provider that dispenses the drugs, and the payments are made in a manner that is not offset by any reconciliation. (m) “Payer” means a health care service plan licensed by the department or a health insurer licensed by the Department of Insurance. (n) “Person” has the same meaning as defined in Section 4035 of the Business and Professions Code. (o) “Personal representative” means an individual who has authority to make a health care decision on behalf of another individual pursuant to Division 4.7 (commencing with Section 4600) of the Probate Code. (p) “Pharmacist” has the same meaning as defined in Section 4036 of the Business and Professions Code. (q) “Pharmacist services” means products, goods, and services, or any combination of products, goods, and services, provided as a part of the practice of pharmacy. (r) “Pharmacy” has the same meaning as defined in Section 4037 of the Business and Professions Code. (s) “Pharmacy benefit management fee” means a flat, defined, dollar-amount fee that covers the cost of providing one or more pharmacy benefit management services and that does not exceed the bona fide value of the itemized service or services actually performed by the pharmacy benefit manager on behalf of the payer, that the payer would otherwise perform or contract for in the absence of the service arrangement, whether or not the payer takes title to the prescription drug. The value of the service or services shall be based on the value to the health insurer or health care service plan. A pharmacy benefit management fee may not directly or indirectly be based on or contingent upon any of the following: (1) The price of prescription drugs, including direct or indirect rebates, discounts, wholesale acquisition cost, drug benchmark price, such as average wholesale price, or other price concessions. (2) The amount of savings, rebates, or other fees charged, realized, or collected by, or generated based on the activity of, the pharmacy benefit manager or its affiliated entities, that is retained by the pharmacy benefit manager or its affiliated entities. (3) The amount of premiums, deductibles, or other cost sharing or fees charged, realized, or collected by the pharmacy benefit manager or its affiliated entities from patients or other persons on behalf of a patient. (4) Coverage or formulary placement decisions or the volume or value of any referrals or business generated between the parties to the arrangement. (5) Any other amounts or methodologies as defined by the director. (t) (1) “Pharmacy benefit manager” means a person, business, or other entity that, either directly or through an intermediary, affiliate, or both, acts as a price negotiator or group purchaser on behalf of a payer, or manages the prescription drug coverage provided by the payer, including, but not limited to, the processing and payment of claims for prescription drugs, the performance of drug utilization review, the processing of drug prior authorization requests, the adjudication of appeals or grievances related to prescription drug coverage, contracting with network pharmacies, or controlling the cost of covered prescription drugs. (2) “Pharmacy benefit manager” includes an entity performing the duties specified in paragraph (1) that is under common ownership with, or control by, a payer. (3) “Pharmacy benefit manager” does not include any of the following: (A) An entity providing services pursuant to a contract authorized by Section 4600.2 of the Labor Code. (B) A fully self-insured employee welfare benefit plan under the Employee Retirement Income Security Act of 1974 (Public Law 93-406), as amended (29 U.S.C. Sec. 1001 et seq.). (C) A health care service plan licensed pursuant to this chapter or an individual employee of a health care service plan. (D) A health insurer licensed to provide health insurance, as defined in Section 106 of the Insurance Code, or an individual employee of a health insurer. (E) A city or county that develops or manages drug coverage programs for uninsured patients for which no reimbursement is received. (F) An entity exclusively providing services to patients covered by Part 418 (commencing with Section 418.1) of Subchapter B of Chapter IV of Title 42 of the Code of Federal Regulations. (G) The State Department of Health Care Services, including any contracts between the State Department of Health Care Services and another entity related to the negotiation and collection of drug or medical supply rebates. (u) “Plan participant” means an individual who is enrolled in health care coverage provided by a payer. (v) (1) “Rebates” means compensation or remuneration of any kind received or recovered from a pharmaceutical manufacturer by a pharmacy benefit manager, affiliated entity, or subcontractor, including a group purchasing organization, directly or indirectly, regardless of how the compensation or remuneration is categorized, including incentive rebates, credits, market share incentives, promotional allowances, commissions, educational grants, market share of utilization, drug pullthrough programs, implementation allowances, clinical detailing, rebate submission fees, and administrative or management fees. (2) “Rebates” also includes fees, including manufacturer administrative fees or corporate fees, that a pharmacy benefit manager, affiliated entity, or subcontractor, including a group purchasing organization, receives from a pharmaceutical manufacturer. (3) “Rebates” does not include pharmacy purchase discounts and related service fees a pharmacy benefit manager, affiliated entity, or subcontractor receives from pharmaceutical companies that are attributable to or based on the purchase of product to stock, or the dispensing of products from a pharmacy benefit manager’s affiliated mail order and specialty drug pharmacies. “Rebates” does not include a pharmacy benefit management fee. (w) “Spread pricing” means the model of prescription drug pricing in which a pharmacy benefit manager charges a health care service plan or health insurer a contracted price for prescription drugs, and the contracted price for the prescription drugs differs from the amount the pharmacy benefit manager directly or indirectly pays the pharmacist or pharmacy. (x) “Third party” means a person that is not a plan participant or pharmacy benefit manager. (Amended (as added by Stats. 2025, Ch. 21, Sec. 11) by Stats. 2025, Ch. 605, Sec. 3. (SB 41) Effective January 1, 2026.)
  89. 1385.0010.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    An application must include authorization for the director to receive certain financial records when requested, including records of affiliated entities.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0010. In addition to the requirements of Section 1385.009, and upon request of the director, an application shall be accompanied by authorization for disclosure to the director of financial records of each pharmacy benefit manager licensed under this chapter, pursuant to Section 7473 of the Government Code. For purposes of this chapter, the authorization for disclosure shall also include the financial records of an association, partnership, or corporation controlling, controlled by, or otherwise affiliated with the pharmacy benefit manager. (Added by Stats. 2025, Ch. 21, Sec. 18. (AB 116) Effective June 30, 2025.)
  90. 1385.0011.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    Pharmacy benefit managers must file annual and quarterly financial statements with the department and provide special reports when the director requires them.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0011. (a) A pharmacy benefit manager shall submit to the department financial statements prepared as of the close of its fiscal year within 120 days after the close of the fiscal year. These financial statements shall be accompanied by a report, certificate, or opinion of an independent certified public accountant or independent public accountant. An audit shall be conducted in accordance with generally accepted auditing standards and the rules and regulations of the director. (b) Within 45 days after the close of each quarter of its fiscal year, a pharmacy benefit manager shall submit its quarterly unaudited financial statement, prepared in accordance with generally accepted accounting principles and consisting of at least a balance sheet, statement of income, statement of cash flows, statement of changes in equity, and notes to financial statements as of the date and for the period specified by the director. The director may require the submission of these reports on a monthly or other periodic basis. (c) A pharmacy benefit manager shall make special reports to the director as the director may require. (d) For good cause and upon written request, the director may extend the time for compliance with subdivisions (a) to (c), inclusive. (e) If the report, certificate, or opinion of the independent accountant required pursuant to subdivision (a) is qualified, the director may require the pharmacy benefit manager to take action that the director deems appropriate to permit an independent accountant to remove the qualification from the report, certificate, or opinion. (f) The director may reject a financial statement, report, certificate, or opinion filed pursuant to this section by notifying the pharmacy benefit manager of the rejection and its cause. Within 30 days after the receipt of the notice, the pharmacy benefit manager shall correct the deficiency, and the failure so to do shall be deemed a violation of this chapter. The director shall retain a copy of all rejected filings. (g) The director may make rules and regulations specifying the form and content of the reports and financial statements required by this section, and may require that these reports and financial statements be verified by the pharmacy benefit manager in a manner as the director may prescribe. Revenue reported by pharmacy benefit managers shall include revenue from manufacturers, payers, and other sources, including from affiliates. Types of revenue reported shall be inclusive of rebates of any type or form. Expenses reported by pharmacy benefit managers shall include payments to pharmacies, claims processing, special programs, administrative costs, and all other expenses. The director may require the reporting of any additional revenue, expenses, or related information that the department requires to assist in determining the overall impact of pharmacy benefit manager business practices on the cost of drugs in this state. (h) To the extent applicable, the department may direct licensure applicants to use the forms and processes available to and required of health care service plans and other entities reporting financial data created pursuant to this chapter and their implementing regulations, including Section 1384 and the forms and exhibits described in regulations, as amended, implementing that section. (i) Financial and other records produced, disclosed, or otherwise made available by an organization pursuant to this section shall be received and maintained on a confidential basis and protected from public disclosure as provided in Section 1385.0021. (Amended by Stats. 2025, Ch. 605, Sec. 4. (SB 41) Effective January 1, 2026.)
  91. 1385.0012.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    Licensed pharmacy benefit managers must send required Chapter 8.5 reporting information to the Department of Health Care Access and Information.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0012. (a) A pharmacy benefit manager licensed pursuant to this article shall submit to the Department of Health Care Access and Information all information required to be reported pursuant to Chapter 8.5 (commencing with Section 127671) of Part 2 of Division 107. (b) The obligation of a pharmacy benefit manager to comply with this section shall not be waived if the pharmacy benefit manager delegates any of its services or business operations to another entity via a contractual relationship or otherwise. (c) Failure by a pharmacy benefit manager to timely or completely submit required reporting to the Department of Health Care Access and Information shall be grounds for enforcement action by the department pursuant to this chapter. (Added by Stats. 2025, Ch. 21, Sec. 20. (AB 116) Effective June 30, 2025.)
  92. 1385.0013.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    A licensed pharmacy benefit manager must update the director after certain changes, including application information, ownership/control changes, operational changes, and listed personnel changes.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0013. (a) (1) A licensed pharmacy benefit manager shall, within 30 days after a change in the information contained in its application, other than financial or statistical information, file an amendment to the application in the manner prescribed by rule by the director. (2) Notwithstanding paragraph (1), if an association, partnership, or corporation is added in a controlling, controlled, or affiliated status relative to the pharmacy benefit manager, the pharmacy benefit manager shall file within 30 days an authorization for disclosure to the director of financial records of the person pursuant to Section 7473 of the Government Code. (b) Before a material modification of its operations, a pharmacy benefit manager shall give notice of the change to the director, who shall approve, disapprove, suspend, or postpone the effectiveness of the change by order, within 20 business days or within additional time specified by the pharmacy benefit manager, subject to Section 1385.0014. (c) A pharmacy benefit manager shall, within five days, give written notice to the director, in the form prescribed by rule by the director, of a change in the officers, directors, partners, controlling shareholders, principal creditors, or persons occupying similar positions or performing similar functions, of the pharmacy benefit manager, any parent company of the pharmacy benefit manager, or a management company of the pharmacy benefit manager or its parent company. The director may define by rule the positions, duties, and relationships that shall be reported pursuant to this subdivision. (d) The fee for filing a notice of material modification pursuant to subdivision (b) shall be the actual cost to the director of processing the notice, including overhead, but shall not exceed seven hundred fifty dollars ($750). (e) Rules and regulations promulgated and amended by the department pursuant to this chapter relating to health care service plan license amendments and material modifications, including those promulgated to implement and make specific Section 1352, shall, to the extent applicable, apply to pharmacy benefit managers licensed pursuant to this article. (Added by Stats. 2025, Ch. 21, Sec. 21. (AB 116) Effective June 30, 2025.)
  93. 1385.0014.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    If licensure is denied, or a material modification is disapproved, suspended, or postponed under Section 1385.0013, the director must give the applicant a written notice stating the reason and explaining the applicant’s hearing right.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0014. Upon denial of an application for licensure, or the issuance of an order pursuant to Section 1385.0013 disapproving, suspending, or postponing a material modification, the director shall notify the applicant in writing, stating the reason for the denial and that the applicant has the right to a hearing if the applicant makes a written request within 30 days after the date of mailing of the notice of denial. Service of the notice required by this section may be made by certified mail addressed to the applicant at the latest address filed by the applicant in writing with the department. (Added by Stats. 2025, Ch. 21, Sec. 22. (AB 116) Effective June 30, 2025.)
  94. 1385.0015.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    A pharmacy benefit manager license stays in effect unless the director revokes or suspends it.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0015. A pharmacy benefit manager license issued under this article shall remain in effect until revoked or suspended by the director. (Added by Stats. 2025, Ch. 21, Sec. 23. (AB 116) Effective June 30, 2025.)
  95. 1385.0016.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    Pharmacy benefit managers applying for licensure must reimburse the director’s application-processing costs, and licensed pharmacy benefit managers must pay annual assessment amounts and file yearly claims reports.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0016. (a) A pharmacy benefit manager applying for licensure under this article shall reimburse the director for the actual cost of processing the application, including overhead, up to an amount not to exceed twenty-five thousand dollars ($25,000). The cost shall be billed not more frequently than monthly and shall be remitted by the applicant to the director within 30 days of the date of billing. The director shall not issue a license to an applicant before receiving payment in full from that applicant for all amounts charged pursuant to this subdivision. (b) (1) In addition to other fees, fines, penalties, and reimbursements required to be paid under this article, a licensed pharmacy benefit manager shall pay to the director an amount estimated by the director, in consultation with the Department of Health Care Access and Information, to be necessary to fund the actual and reasonably necessary expenses of the department to implement this article and the actual and reasonably necessary expenses of the Department of Health Care Access and Information pertaining to data reporting by pharmacy benefit managers, including for any portion of the Health Care Payments Data Program established by Section 127671.1 that is necessary to implement the provisions of this article, for the ensuing fiscal year. The amount may be paid in two equal installments. The first installment shall be paid on or before August 1 of each year, and the second installment shall be paid on or before December 15 of each year. (2) The total assessment cost for all licensed pharmacy benefit managers determined by the director pursuant to paragraph (1) shall be divided pro rata among licensees based upon each licensee’s share of the aggregate number of claims adjudicated in this state by licensed pharmacy benefit managers. The aggregate number of claims adjudicated in this state and each licensee’s share of that number shall be calculated based on the report that licensees are required to submit pursuant to paragraph (3). (3) A licensed pharmacy benefit manager shall, by January 31 of each year, file with the director a report stating the total number of claims it adjudicated for drugs in this state for the preceding calendar year. For purposes of this paragraph, adjudicated claims are claims for reimbursement for drugs dispensed by a provider to a beneficiary under the drug benefit administered by the pharmacy benefit manager for which payment was authorized and made by the pharmacy benefit manager. Reports submitted shall be in the form and manner directed by the department. Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may issue instructions on reporting without taking regulatory action. (4) The amount paid by each pharmacy benefit manager shall be fixed by the director by notice to all licensed pharmacy benefit managers on or before June 15 of each year. A pharmacy benefit manager that is unable to report the number of adjudicated claims shall provide the director with an estimate of the number and the method used for determining the estimate. The director may, upon giving written notice to the pharmacy benefit manager, revise the estimate if the director determines that the method used for determining the estimate was not reasonable. (5) In determining the amount assessed, the director shall consider all appropriations from the Pharmacy Benefit Manager Fund for the support of the administration of this article and other relevant reimbursements provided for in this chapter. (6) A refund or reduction of the amount assessed shall not be provided if a miscalculated assessment is based on a pharmacy benefit manager’s overestimate of adjudicated claims. (Added by Stats. 2025, Ch. 21, Sec. 24. (AB 116) Effective June 30, 2025.)
  96. 1385.0017.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    This section creates the Pharmacy Benefit Manager Fund, requires certain department revenues to be deposited into it, allows a transfer to the Health Care Payments Data Fund with legislative appropriation, and limits the fund’s reserve to 5% unless the Department of Finance decides otherwise.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0017. (a) To support the department in the administration of this article and the effective regulation of pharmacy benefit managers under this chapter, and to support the Department of Health Care Access and Information as it pertains to data regarding pharmacy benefit managers and the cost of drugs in this state, the Pharmacy Benefit Manager Fund, administered by the Department of Managed Health Care, is hereby established in the State Treasury. (b) All revenues of the department received pursuant to this article, including fees, fines, penalties, and reimbursements, except those collected pursuant to Section 1385.0018, shall be deposited in the Pharmacy Benefit Manager Fund and subject to an appropriation by the Legislature. (c) The department may transfer any revenues deposited into the Pharmacy Benefit Manager Fund to the Health Care Payments Data Fund, established pursuant to Section 127674, for use by the Department of Health Care Access and Information, upon appropriation by the Legislature, for the administration of the Health Care Payments Data System. (d) In any fiscal year, the Pharmacy Benefit Manager Fund shall maintain not more than a prudent 5-percent reserve unless otherwise determined by the Department of Finance. (Added by Stats. 2025, Ch. 21, Sec. 25. (AB 116) Effective June 30, 2025.)
  97. 1385.0018.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    The director may suspend or revoke a pharmacy benefit manager’s license, or assess administrative penalties, if disciplinary grounds are found.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0018. (a) The director may, after appropriate notice and opportunity for a hearing, by order suspend or revoke a license issued under this article to a pharmacy benefit manager or assess administrative penalties if the director determines that the licensee has committed an act or omission constituting grounds for disciplinary action. (b) All of the following acts or omissions constitute grounds for disciplinary action by the director: (1) The pharmacy benefit manager is operating at variance with basic organizational documents as filed pursuant to Section 1385.009, or with its published plan, or in a manner contrary to that described in, and reasonably inferred from, the plan as contained in its application for licensure and annual report, or any modification thereof, unless amendments allowing the variation have been submitted to, and approved by, the director. (2) The continued operation of the pharmacy benefit manager shall constitute a substantial risk to its subscribers and enrollees. (3) The pharmacy benefit manager has violated, attempted to violate, or conspired to violate, directly or indirectly, or assisted in or abetted a violation or conspiracy to violate a provision of this chapter, a rule or regulation adopted by the director pursuant to this chapter, or an order issued by the director pursuant to this chapter. (4) The pharmacy benefit manager has engaged in conduct that constitutes fraud, dishonest dealing, or unfair competition, as defined by Section 17200 of the Business and Professions Code. (5) The pharmacy benefit manager has permitted, aided, or abetted a violation by an employee or contractor who is a holder of a certificate, license, permit, registration, or exemption issued pursuant to the Business and Professions Code or this code that would constitute grounds for discipline against the certificate, license, permit, registration, or exemption. (6) The pharmacy benefit manager has permitted, aided, or abetted the commission of an illegal act. (7) The pharmacy benefit manager, its management company, another affiliate of the pharmacy benefit manager, or a controlling person, officer, director, or other person occupying a principal management or supervisory position in the pharmacy benefit manager, management company, or affiliate, has been convicted of or pleaded nolo contendere to a crime, or committed an act involving dishonesty, fraud, or deceit, which crime or act is substantially related to the qualifications, functions, or duties of a person engaged in business in accordance with this chapter. The director may revoke or deny a license hereunder irrespective of a subsequent order under Section 1203.4 of the Penal Code. (8) The pharmacy benefit manager has been subject to a final disciplinary action taken by this state, another state, an agency of the federal government, or another country for an act or omission that would constitute a violation of this chapter. (9) The pharmacy benefit manager violated the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code). (10) The pharmacy benefit manager violated Chapter 8.5 (commencing with Section 127671) of Part 2 of Division 107, including the data submission requirements of that chapter. (c) The assessment of administrative penalties against a pharmacy benefit manager shall use the same factors described in subdivision (d) of Section 1386 for health care service plans. (d) A pharmacy benefit manager shall be subject, if applicable, to all enforcement authority of the department set forth in Article 8 (commencing with Section 1390), and civil penalties for violation of the licensure requirement of Section 1385.009. (e) Fines and administrative penalties collected pursuant to this section shall be deposited into the Pharmacy Benefit Manager Administrative Fines and Penalties Fund established pursuant to Section 1385.0024. These fines and administrative penalties shall not be used to reduce the assessments imposed on pharmacy benefit managers pursuant to Section 1385.0016. (Added by Stats. 2025, Ch. 21, Sec. 26. (AB 116) Effective June 30, 2025.)
  98. 1385.0019.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    A pharmacy benefit manager with a revoked license, or a suspension lasting more than one year, may ask the director to reinstate it, but the petition can be blocked if the petitioner is under a criminal sentence for certain offenses.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0019. (a) A pharmacy benefit manager whose license has been revoked, or suspended for more than one year, may petition the director to reinstate the license as provided by Section 11522 of the Government Code. A petition shall not be considered if the petitioner is under criminal sentence for a violation of this chapter, or an offense that would constitute grounds for discipline or denial of licensure under this chapter, including any period of probation or parole. (b) The petition for restoration shall be in the form prescribed by the director. The director may condition the granting of the petition upon additional information and undertakings as the director requires to determine if the person, if restored, would engage in business in full compliance with this chapter and the rules and regulations adopted by the director pursuant to this chapter. (c) The director may prescribe a fee not to exceed five hundred dollars ($500) for the filing of a petition for restoration pursuant to this section, which shall be the actual cost to the director of processing the petition. In addition, the director may condition the granting of a petition to a pharmacy benefit manager upon payment of the assessment due and unpaid pursuant to subdivision (b) of Section 1385.0016 as of December 15 in the preceding 12 calendar months and, if the pharmacy benefit manager’s suspension or revocation was in effect for more than 12 months, upon the filing of a new pharmacy benefit manager licensure application and the payment of the fee prescribed by subdivision (a) of Section 1385.0016. (Added by Stats. 2025, Ch. 21, Sec. 27. (AB 116) Effective June 30, 2025.)
  99. 1385.002.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    The department may enforce this article, issue or change rules, use letters or similar instructions to explain it, and hire consultants for implementation until June 30, 2028.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.002. (a) The department has the authority to enforce the provisions of this article, including the authority to adopt, amend, or repeal any rules and regulations, not inconsistent with the laws of this state, as may be necessary for the protection of the public and to implement this article, including, but not limited to, the director’s enforcement authority under this chapter. (b) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this article by means of all-plan letters or similar instructions to plans and pharmacy benefit managers, without taking regulatory action, until such time as regulations are adopted. (c) Until June 30, 2028, for purposes of implementing this article, the department may contract with a consultant or consultants, including information technology consultants and vendors, with relevant expertise to assist the department with implementing this article. The department’s contract with a consultant shall include conflict-of-interest provisions to prohibit a person from participating in any report in which the person knows or has reason to know the person has a material financial interest, including, but not limited to, a person who has a consulting or other agreement with a person or organization that would be affected by the results of the report. (d) Contracts entered into pursuant to the authority in this section shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Section 19130 of the Government Code, and Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and shall be exempt from the review or approval of any division of the Department of General Services. (Amended by Stats. 2025, Ch. 21, Sec. 12. (AB 116) Effective June 30, 2025.)
  100. 1385.0020.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    A pharmacy benefit manager license surrender normally takes effect after 30 days, but the director can shorten that time or set different terms in some cases. The director may also summarily revoke or suspend the license if certain conditions are met.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0020. (a) Surrender of a pharmacy benefit manager license shall become effective 30 days after receipt of an application to surrender the license or within a shorter period of time as the director may determine to be in the public interest and not detrimental to the protection of subscribers, enrollees, or persons regulated under this chapter, unless a revocation or suspension proceeding is pending when the application is filed or a proceeding to revoke or suspend or to impose conditions upon the surrender is instituted within 30 days after the application is filed. If this proceeding is pending or instituted, surrender becomes effective at the time and upon the conditions as the director determines by order. (b) If the director finds that a pharmacy benefit manager is no longer in existence, has ceased to do business, has failed to initiate business activity as a licensee within six months after licensure, or cannot be located after reasonable search, the director may, by order, summarily revoke the license of the pharmacy benefit manager. (c) The director may summarily suspend or revoke the license of a pharmacy benefit manager upon failure to pay a fee required by this chapter within 15 days after notice by the director that the fee is due and unpaid or failure to file an amendment or report required under this article within 15 days after notice by the director that the report is due. (Added by Stats. 2025, Ch. 21, Sec. 28. (AB 116) Effective June 30, 2025.)
  101. 1385.0021.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

    Verify source ↗

    The director generally does not have to disclose certain pharmacy benefit manager records, but must disclose records to the Attorney General upon request for related enforcement or court proceedings.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0021. (a) Notwithstanding the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code), the director is not required to disclose any of the following records, or any portion thereof, that are filed by a pharmacy benefit manager with the director in compliance with the requirements of this article, that have not previously been made public: (1) Corporate financial records, including trade secrets, the information has been confidentially maintained by the business entity, and the release of the information would be damaging or prejudicial to the business concern. (2) Any application, including an application for an interpretive opinion, including all records that are submitted with the application that are necessary for purposes of the application. (3) Any record the disclosure of which is exempt under express provisions of the California Public Records Act, the disclosure of which is exempt or prohibited pursuant to federal or state law, including, but not limited to, provisions of the Evidence Code relating to privilege, or that, on the facts of the particular case, the public interest served by not disclosing the record clearly outweighs the public interest served by disclosure of the record. (b) Notwithstanding any request for confidentiality of information submitted to and processed by the department consistent with regulations adopted and amended pursuant to this chapter relating to the request for confidentiality of information, the disclosure of records, or any portion thereof, is governed by this section. (c) Notwithstanding any other provision of this article, the director shall disclose information or records submitted to the director in compliance with this article to the Attorney General, upon request, in order to investigate, prosecute, or defend any legal claim or cause or action related to this article, or to use the reports in any court or proceeding related to this article. (Amended by Stats. 2025, Ch. 605, Sec. 5. (SB 41) Effective January 1, 2026.)
  102. 1385.0022.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

    Verify source ↗

    A pharmacy benefit manager must act fairly, truthfully, and in the payer client’s best interests, avoid conflicts of interest, and use care, skill, prudence, and diligence.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0022. A pharmacy benefit manager has a fiduciary duty to its payer client that includes a duty to be fair and truthful toward the payer, to act in the payer’s best interests, to avoid conflicts of interest, and to perform its duties with care, skill, prudence, and diligence. This section does not limit a payer’s obligations under applicable law with respect to the administration of health care coverage for plan participants. (Amended by Stats. 2025, Ch. 605, Sec. 6. (SB 41) Effective January 1, 2026.)
  103. 1385.0023.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    The department may survey or examine pharmacy benefit managers, and complaints about a pharmacy benefit manager can be treated as complaints against the related health care service plan or insurer.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0023. (a) The department may conduct periodic routine and nonroutine surveys of a pharmacy benefit manager. These surveys shall be conducted in accordance with Section 1380, as applicable. (b) The department may conduct periodic routine and nonroutine examinations of the fiscal and administrative affairs of a pharmacy benefit manager. These examinations shall be conducted in accordance with Section 1382, as applicable. (c) A complaint made by an enrollee that includes potential violations by a pharmacy benefit manager of the terms of this article shall be considered by the department to be a complaint against the health care service plan. A complaint made by an insured that includes potential violations by a pharmacy benefit manager of the terms of this article may be considered by the Department of Insurance to be a complaint against the insurer. (Amended by Stats. 2025, Ch. 605, Sec. 7. (SB 41) Effective January 1, 2026.)
  104. 1385.0024.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    This section creates the Pharmacy Benefit Manager Administrative Fines and Penalties Fund, directs certain fines and penalties into it starting July 1, 2025, allows limited transfers of those funds, and bars using them to reduce pharmacy benefit manager assessments.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0024. (a) The Pharmacy Benefit Manager Administrative Fines and Penalties Fund is hereby created in the State Treasury. (b) On and after July 1, 2025, the fines and administrative penalties collected pursuant to Section 1385.0018 shall be deposited into the Pharmacy Benefit Manager Administrative Fines and Penalties Fund. (c) Fines and administrative penalties deposited into the Pharmacy Benefit Manager Administrative Fines and Penalties Fund may be transferred into the Health Care Payments Data Fund, established pursuant to Section 127674, for use by the Department of Health Care Access and Information, upon appropriation by the Legislature, for the administration of the Health Care Payments Data System. (d) Fines and administrative penalties deposited into the Pharmacy Benefit Manager Administrative Fines and Penalties Fund may be transferred, subject to the annual budget process, to the Health Care Services Plan Fines and Penalties Fund, established pursuant to Section 15893 of the Welfare and Institutions Code. (e) Fines and administrative penalties deposited into the Pharmacy Benefit Manager Administrative Fines and Penalties Fund shall not be used to reduce the assessments imposed on pharmacy benefit managers pursuant to Section 1385.0016. (Added by Stats. 2025, Ch. 21, Sec. 32. (AB 116) Effective June 30, 2025.)
  105. 1385.0025.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    This section says the article is severable, so if one provision or application is invalid, the rest can still operate.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0025. The provisions of this article are severable. If any provision of this article or its application is held invalid, that invalidity shall not affect other provisions or applications that can be given effect without the invalid provision or application. (Added by Stats. 2025, Ch. 21, Sec. 33. (AB 116) Effective June 30, 2025.)
  106. 1385.0026.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    A pharmacy benefit manager must not discriminate against a nonaffiliated pharmacy when handling drug dispensing, but may establish a network of contracting pharmacies.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0026. (a) A pharmacy benefit manager shall not impose any requirements, conditions, or exclusions that discriminate against a nonaffiliated pharmacy in connection with dispensing drugs. (b) Discrimination prohibited pursuant to subdivision (a) includes all of the following: (1) Terms or conditions applied to nonaffiliated pharmacies based on their status as a nonaffiliated pharmacy. (2) Refusing to contract with or terminating a contract with a nonaffiliated pharmacy on the basis that the pharmacy is a nonaffiliated pharmacy or for reasons other than those that apply equally to affiliated pharmacies. (3) Retaliation against a nonaffiliated pharmacy based on its exercise of any right or remedy under this article. (4) Engaging in an unlawful action against a covered entity, including a violation of Section 127471. (5) Reimbursing a nonaffiliated pharmacy less for a pharmacist service than the pharmacy benefit manager would reimburse an affiliated pharmacy for the same pharmacist service. (c) This article does not preclude a pharmacy benefit manager or a purchaser of pharmacy benefit manager services from establishing a network of contracting pharmacies. (Added by Stats. 2025, Ch. 605, Sec. 8. (SB 41) Effective January 1, 2026.)
  107. 1385.0027.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    A pharmacy benefit manager must not steer plan participants or pharmacies toward affiliated pharmacies in the listed ways, but may offer financial incentives like lower copays or coinsurance.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0027. A pharmacy benefit manager shall not do any of the following: (a) Require a plan participant to use only an affiliated pharmacy if there are nonaffiliated pharmacies in the network. (b) Financially induce a plan participant to transfer a prescription only to an affiliated pharmacy if there are nonaffiliated pharmacies in the network. (c) Require a nonaffiliated pharmacy to transfer a prescription to an affiliated pharmacy if there are nonaffiliated pharmacies in the network. This section does not prevent a purchaser or pharmacy benefit manager from offering to plan participants financial incentives to use a particular pharmacy, such as lower copays, coinsurance, or any other cost sharing for a prescription when the prescription is dispensed. (d) Unreasonably restrict a plan participant from using a particular contracted pharmacy for the purpose of receiving pharmacist services covered by the plan participant’s contract or policy. (e) Communicate to or mislead a plan participant, in any manner, that the plan participant is required to have a prescription dispensed at, or pharmacy services provided by, a particular affiliated pharmacy or pharmacies if there are other nonaffiliated pharmacies that have the ability to dispense the medication or provide the services and are also in network. (f) Deny a nonaffiliated contract pharmacy the opportunity to participate in a pharmacy benefit manager network as preferred participation status if the pharmacy is willing to accept the same terms and conditions that the pharmacy benefit manager has established for affiliated pharmacies as a condition of preferred network participation status. (Added by Stats. 2025, Ch. 605, Sec. 9. (SB 41) Effective January 1, 2026.)
  108. 1385.0028.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    Certain pharmacy contracts may not block the pharmacy from offering specified delivery services starting with contracts issued, amended, or renewed on or after January 1, 2026.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0028. (a) A contract issued, amended, or renewed on or after January 1, 2026, between a nonaffiliated pharmacy and a pharmacy benefit manager shall not prohibit the pharmacy from offering either of the following as an ancillary service of the pharmacy: (1) The delivery of a prescription drug by mail or common carrier to a patient or personal representative on request of the patient or personal representative if the request is made before the drug is delivered. (2) The delivery of a prescription to a patient or personal representative by an employee or contractor of the pharmacy. (b) Except as otherwise provided in a contract described in subdivision (a), the pharmacy shall not charge a pharmacy benefit manager for the delivery service described in subdivision (a). This section does not prohibit the use of remote pharmacies, secure locker systems, or other types of pickup stations if those services are otherwise permitted by law. (c) Contracts entered into pursuant to this section shall be open for inspection by the department. (Added by Stats. 2025, Ch. 605, Sec. 10. (SB 41) Effective January 1, 2026.)
  109. 1385.0029.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    Pharmacy benefit managers must disclose fees, use passthrough pricing, pass manufacturer rebates through in required cases, and avoid prohibited claim, payment, and retaliation practices.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0029. (a) A pharmacy benefit manager shall not derive income from pharmacy benefit management services provided to a payer in this state except for income derived from a pharmacy benefit management fee for pharmacy benefit management services provided. The amount of any pharmacy benefit management fee shall be set forth in the agreement between the pharmacy benefit manager and the payer. The pharmacy benefit manager shall disclose the amount and types of the pharmacy benefit management fees to the payer. (b) A pharmacy benefit manager shall use a passthrough pricing model. (c) A pharmacy benefit manager, group purchasing organization, and affiliated entity shall direct 100 percent of all prescription drug manufacturer rebates received to the payer or program, if the contractual arrangement delegates the negotiation of rebates to the pharmacy benefit manager, group purchasing organization, or affiliated entity, for the sole purpose of offsetting defined cost sharing, deductibles, and coinsurance contributions and reducing premiums of plan participants. (d) (1) This section does not preclude a payer from paying performance bonuses to a pharmacy benefit manager based on savings to the payer that decrease premiums paid by the plan participant or that result in plan participants paying the lowest level of cost sharing, deductibles, and coinsurance for a drug, as long as the performance bonus is not based or contingent on any of the following: (A) The acquisition or ingredient cost of a drug. (B) The amount of savings, rebates, or other fees charged, realized, or collected by, or generated based on the activity of, the pharmacy benefit manager or its affiliated entities that is retained by the pharmacy benefit manager. (C) The amount of premiums, deductibles, or other cost sharing or fees charged, realized, or collected by the pharmacy benefit manager or its affiliated entities from patients or other persons on behalf of a patient, except for performance bonuses that are based or contingent on a decrease in premiums, deductibles, or other cost sharing. (2) Compensation arrangements governed by this section shall be open for inspection by the department. (e) A pharmacy benefit manager shall not make or permit any reduction of payment for pharmacist services by a pharmacy benefit manager or a payer directly or indirectly to a pharmacy under a reconciliation process to an effective rate of reimbursement, including without limitation generic effective rates, brand effective rates, direct and indirect remuneration fees, or any other reduction or aggregate reduction of payment. (f) A claim or aggregate of claims for pharmacist services shall not be directly or indirectly retroactively denied or reduced after adjudication of the claim or aggregate of claims unless any of the following have occurred: (1) The original claim was submitted fraudulently. (2) The original claim payment was incorrect because the pharmacy or pharmacist had already been paid for the pharmacist services. (3) The pharmacist services were not properly rendered by the pharmacy or pharmacist. (g) A pharmacy benefit manager shall not reverse and resubmit the claim of a contract pharmacy under any of the following circumstances: (1) Without prior written notification to the contract pharmacy. (2) Without just cause or attempt to first reconcile the claim with the pharmacy. (3) More than 90 days after the claim was first affirmatively adjudicated. (h) A pharmacy benefit manager shall not charge a pharmacy or pharmacist a fee to process a claim electronically. (i) The termination of a contract with a nonaffiliated pharmacy by a pharmacy benefit manager shall not release the pharmacy benefit manager from the obligation to make a payment due to the pharmacy for an affirmatively adjudicated claim unless payments are withheld because of an investigation relating to insurance fraud. (j) A pharmacy benefit manager shall not retaliate against a pharmacist or pharmacy based on the pharmacist’s or pharmacy’s exercise of a right or remedy under this chapter. Prohibited retaliation includes any of the following: (1) Terminating or refusing to renew a contract with the pharmacist or pharmacy. (2) Subjecting the pharmacist or pharmacy to increased audits without cause. (3) Failing to promptly pay the pharmacist or pharmacy money owed by the pharmacy benefit manager to the pharmacist or pharmacy. (Added by Stats. 2025, Ch. 605, Sec. 11. (SB 41) Effective January 1, 2026.)
  110. 1385.003.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    A health care service plan must share certain prescription drug information with a contracted pharmacy provider or its agent, and it cannot contract to stop the provider from telling a patient about a cheaper medication alternative.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.003. (a) A health care service plan shall disclose to a contracted pharmacy provider or its contracting agent the prescription drug information contained in subdivision (a) of Section 1363.03, including, but not limited to, the telephone number pharmacy providers may call for assistance and information necessary to process a pharmacy claim. (b) A health care service plan shall not include in a contract with a pharmacy provider or its contracting agent a provision that prohibits the provider from informing a patient of a less costly alternative to a prescribed medication. (Added by Stats. 2018, Ch. 905, Sec. 4. (AB 315) Effective January 1, 2019. Operative on January 1, 2020, pursuant to Section 1385.002.)
  111. 1385.0031.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    A pharmacy benefit manager may not conduct spread pricing in this state starting January 1, 2026.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0031. Commencing January 1, 2026, a pharmacy benefit manager shall not conduct spread pricing in this state. If a preexisting contract between a pharmacy benefit manager and a payer authorizes spread pricing, a subsequent amendment or renewal of that contract shall not contain that authorization. Spread pricing contract terms shall be void on and after January 1, 2029. (Added by Stats. 2025, Ch. 605, Sec. 12. (SB 41) Effective January 1, 2026.)
  112. 1385.0032.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    A pharmacy benefit manager must not make certain California contracts involving exclusivity after January 1, 2026, unless it can show the exclusivity produces the lowest cost to the payer and the lowest cost sharing for the plan participant.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0032. (a) Notwithstanding any other law, a pharmacy benefit manager shall not enter into, amend, enforce, or renew a contract on or after January 1, 2026, with manufacturers that do business in California that implement implicit or express exclusivity for those manufacturers’ drugs, unless the pharmacy benefit manager can demonstrate the extent to which exclusivity results in the lowest cost to the payer, and the lowest cost sharing for the plan participant. (b) Notwithstanding any other law, a pharmacy benefit manager shall not enter into, amend, enforce, or renew a contract on or after January 1, 2026, with pharmacies or pharmacy services administration organizations that do business in California that expressly or implicitly restrict, or impose implicit or express exclusivity on, nonaffiliated pharmacies’ ability to contract with employers and payers. (c) Contracts entered into pursuant to this section shall be open for inspection and audit by the department. (Added by Stats. 2025, Ch. 605, Sec. 13. (SB 41) Effective January 1, 2026.)
  113. 1385.0033.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    Violators of this article can be sued for an injunction and a civil penalty, and the Attorney General can seek broader equitable relief and attorney’s fees and costs.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0033. (a) A person that violates this article shall be subject to an injunction and liable for a civil penalty of not less than one thousand dollars ($1,000) or more than seven thousand five hundred dollars ($7,500) for each violation, which shall be assessed and recovered in a civil action brought in the name of the people of the State of California by the Attorney General. (b) Notwithstanding any other law, the Attorney General shall be entitled to specific performance, injunctive relief, and other equitable remedies a court deems appropriate for enforcement of this article and shall be entitled to recover attorney’s fees and costs incurred in remedying each violation. (Added by Stats. 2025, Ch. 605, Sec. 14. (SB 41) Effective January 1, 2026.)
  114. 1385.0034.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    This article does not apply to certain collectively bargained Taft-Hartley self-insured prescription drug plans, or to PBM services provided for those plans.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.0034. This article does not apply to a collectively bargained Taft-Hartley self-insured prescription drug plan offered pursuant to the federal Employee Retirement Income Security Act of 1974 (29 U.S.C. Sec. 1001 et seq.) or to a pharmacy benefit manager’s provision of pharmacy benefit management services pursuant to that Taft-Hartley plan. To the extent a pharmacy benefit manager is providing services for other payers in addition to a collectively bargained self-insured plan that provides prescription drug plans governed by federal law, this article shall apply to the pharmacy benefit manager in its performance of pharmacy benefit management services pursuant to those other payers. (Added by Stats. 2025, Ch. 605, Sec. 15. (SB 41) Effective January 1, 2026.)
  115. 1385.004.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    A health care service plan that contracts with a pharmacy benefit manager must require the manager to follow specified rules, including registration or licensing, good faith performance, compliance with related laws, notice to pharmacists, post-2026 reporting, and written notice of conflicts of interest.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.004. (a) A health care service plan that contracts with a pharmacy benefit manager for management of any or all of its prescription drug coverage shall require the pharmacy benefit manager to do all of the following: (1) Comply with the provisions of Section 1385.003. (2) Register with the department pursuant to the requirements of this article, or, if licensure of the pharmacy benefit manager is required pursuant to this article, obtain a license and keep it in good standing with the department. (3) Exercise good faith and fair dealing in the performance of its contractual duties to a health care service plan. (4) Comply with the requirements of Chapter 9.5 (commencing with Section 4430) of Division 2 of the Business and Professions Code, as applicable. (5) Inform all pharmacists under contract with or subject to contracts with the pharmacy benefit manager of the pharmacist’s rights to submit complaints to the department under Section 1371.39 and of the pharmacist’s rights as a provider under Section 1375.7. (b) Contracts issued, amended, or renewed on or after January 1, 2026, between a health care service plan and a pharmacy benefit manager shall require the pharmacy benefit manager to submit to the Department of Health Care Access and Information all information required to be reported pursuant to Chapter 8.5 (commencing with Section 127671) of Part 2 of Division 107. (c) A pharmacy benefit manager shall notify a health care service plan in writing of any activity, policy, or practice of the pharmacy benefit manager that directly or indirectly presents a conflict of interest that interferes with the discharge of the pharmacy benefit manager’s duty to the health care service plan to exercise good faith and fair dealing in the performance of its contractual duties pursuant to subdivision (a). (Amended by Stats. 2025, Ch. 21, Sec. 13. (AB 116) Effective June 30, 2025.)
  116. 1385.005.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    Pharmacy benefit managers that must register with the department must file a registration application, provide specified information, and report changes within 30 days. The registration is not transferable.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.005. (a) A pharmacy benefit manager required to register with the department pursuant to Section 1385.004 shall complete an application for registration with the department that shall include, but not be limited to, all of the information required by subdivision (c). (b) A pharmacy benefit manager registration obtained pursuant to this section is not transferable. (c) The department shall develop an application form for pharmacy benefit manager registration. The application form for a pharmacy benefit manager registration shall require the pharmacy benefit manager to submit the following information to the department: (1) The name of the pharmacy benefit manager. (2) The address and contact telephone number for the pharmacy benefit manager. (3) The name and address of the pharmacy benefit manager’s agent for service of process in the state. (4) The name and address of each person beneficially interested in the pharmacy benefit manager. (5) The name and address of each person with management or control over the pharmacy benefit manager. (d) If the applicant is a partnership or other unincorporated association, a limited liability company, or a corporation, and the number of partners, members, or stockholders, as the case may be, exceeds five, the application shall so state, and shall further state the name, address, usual occupation, and professional qualifications of each of the five partners, members, or stockholders who own the five largest interests in the applicant entity. Upon request by the department, the applicant shall furnish the department with the name, address, usual occupation, and professional qualifications of partners, members, or stockholders not named in the application, or shall refer the department to an appropriate source for that information. (e) The application shall contain a statement to the effect that the applicant has not been convicted of a felony and has not violated any of the provisions of this article. If the applicant cannot make this statement, the application shall contain a statement of the violation, if any, or shall describe the reasons that prevent the applicant from being able to comply with the requirements with respect to the statement. (f) The department may set a fee for a registration required by this article. The application fee shall not exceed the reasonable costs of the department in carrying out its duties under this article. (g) Within 30 days of a change in any of the information disclosed to the department on an application for a registration, the pharmacy benefit manager shall notify the department of that change in writing. (h) For purposes of this section, “person beneficially interested” with respect to a pharmacy benefit manager means and includes the following: (1) If the applicant is a partnership or other unincorporated association, each partner or member. (2) If the applicant is a corporation, each of its officers, directors, and stockholders, provided that a natural person shall not be deemed to be beneficially interested in a nonprofit corporation. (3) If the applicant is a limited liability company, each officer, manager, or member. (i) This section shall become inoperative on January 1, 2027, or the date on which the department has established the licensure process pursuant to Section 1385.009, whichever is later and, as of the following January 1 is repealed. (Amended by Stats. 2025, Ch. 21, Sec. 14. (AB 116) Effective June 30, 2025. Conditionally inoperative on or after January 1, 2027, by its own provisions. Repealed conditionally by its own provisions.)
  117. 1385.006.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    A health care service plan’s failure to meet contractual requirements or properly oversee a contracted pharmacy benefit manager can lead to disciplinary action. The director must investigate and take enforcement action as appropriate, and must periodically review contracts for possible audit, evaluation, or enforcement steps.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.006. The failure by a health care service plan to comply with the contractual requirements and to maintain appropriate oversight of a contracted pharmacy benefit manager to ensure the pharmacy benefit manager’s compliance pursuant to this article shall constitute grounds for disciplinary action. The director shall, as appropriate, investigate and take enforcement action against a health care service plan that fails to comply with these requirements and shall periodically evaluate contracts between health care service plans and pharmacy benefit managers to determine if any audit, evaluation, or enforcement actions should be undertaken by the department. (Amended by Stats. 2025, Ch. 21, Sec. 15. (AB 116) Effective June 30, 2025.)
  118. 1385.008.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    A person may not operate as a pharmacy benefit manager for a payer in this state on or after the stated trigger date unless first licensed by the director.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.008. On or after January 1, 2027, or the date on which the department has established the licensure process pursuant to Section 1385.009, whichever is later, a person shall not engage in business as a pharmacy benefit manager for a payer in this state unless that person has first secured a license from the director. A license issued pursuant to this article is not transferable without the express and specific permission of the director. (Added by Stats. 2025, Ch. 21, Sec. 16. (AB 116) Effective June 30, 2025.)
  119. 1385.009.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. )

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    An applicant for pharmacy benefit manager licensure must submit a verified application in the department’s form, pay the required fee, and include a long list of documents, disclosures, and affirmations.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.1. Pharmacy Benefit Managers [1385.001 - 1385.009] ( Heading of Article 6.1 amended by Stats. 2025, Ch. 21, Sec. 9. ) ## 1385.009. An application for licensure as a pharmacy benefit manager under this article shall be verified by an authorized representative of the applicant and shall be in a form prescribed by the department. To the extent applicable, the department may direct licensure applicants to use the forms and processes available to and required of health care service plan licensure applicants and licensees created pursuant to this chapter and its implementing regulations, including Section 1351 and the forms and exhibits described in regulations, as amended, implementing that section. The application for licensure as a pharmacy benefit manager shall be accompanied by the fee prescribed by Section 1385.0016 and shall set forth or be accompanied by all of the following: (a) The basic organizational documents of the applicant, such as the articles of incorporation, articles of association, partnership agreement, trust agreement, or other applicable documents, and all amendments to those documents. (b) A copy of the bylaws, rules and regulations, or similar documents regulating the conduct of the internal affairs of the applicant. (c) A list of the names, addresses, and official positions of the persons who are to be responsible for the conduct of the affairs of the applicant, including all members of the board of directors, board of trustees, executive committee, or other governing board or committee, the principal officers, each shareholder with more than 5 percent interest in the case of a corporation, all partners or members in the case of a partnership or association, and each person who has loaned funds to the applicant for the operation of its business. (d) A statement of whether, within the preceding 10 years, the applicant, its management company, an affiliate of the applicant, a controlling person, officer, director, or other person occupying a principal management or supervisory position in the pharmacy benefit manager, management company, or affiliate, or a person intended to hold that relationship or position, has been convicted of or pleaded nolo contendere to a felony, been held to have committed an act involving dishonesty, fraud, or deceit in a judicial or administrative proceeding to which the person was a party, or has had a license or certificate to operate as a pharmacy benefit manager denied or revoked in another jurisdiction. (e) For an applicant not domiciled in this state, a power of attorney duly executed appointing the director the true and lawful attorney in fact of the applicant for the purposes of service of all lawful process in a legal action or proceeding against the pharmacy benefit manager on a cause of action arising in this state. (f) Financial statements accompanied by a report, certificate, or opinion of an independent certified public accountant that demonstrates the financial viability of the applicant. Submission of financial statements may, at the direction of the department, be completed using the same forms and processes as required for health care service plans licensed pursuant to this chapter. (g) An affirmation that the applicant’s business practices and contracts comply with the applicable provisions of this chapter, including the requirements of pharmacy benefit manager contracts and business practices set forth in this article. (h) An affirmation that the applicant shall comply with all requirements for reporting data to the Department of Health Care Access and Information in accordance with this article and Chapter 8.5 (commencing with Section 127671) of Part 2 of Division 107. (i) A description of the business operations of the applicant, including descriptions of its services, facilities, and personnel. (j) A list of all jurisdictions in which the applicant operates as a pharmacy benefit manager, including those in which the applicant holds a license, registration, or certification as a pharmacy benefit manager. (k) The applicant’s organization chart or charts that show the lines of responsibility and authority in the administration of the applicant’s business as a pharmacy benefit manager. The applicant shall include a narrative explanation of the organization chart, including the responsibility and authority of each entity, board, committee, and position, and identify the persons who serve on the boards and committees and in those positions. (l) A list of all pharmaceutical supply chain entities, including drug manufacturers, wholesalers, and distributors, that are contracted or affiliated with the applicant. (m) A list of all health care providers, including pharmacies and pharmacists, that are contracted or affiliated with the applicant. (n) A list of each payer with which the applicant is affiliated or has a contract for the provision of pharmacy benefit manager services, including a description of all services provided and the number of individual enrollees covered under the contract or contracts with each payer. (o) A statement describing how the applicant shall provide for separation of medical and clinical decisionmaking from fiscal and administrative management to ensure that medical and clinical decisions shall not be unduly influenced by fiscal and administrative management, including a description of what controls will be put into place to assure compliance with this requirement. (Added by Stats. 2025, Ch. 21, Sec. 17. (AB 116) Effective June 30, 2025.)
  120. 1385.01.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    This section defines key terms used in the article on review of rate increases.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.01. For purposes of this article, the following definitions shall apply: (a) (1) “Blended” means a rating method that combines community rating and experience rating methods. (2) “Community rated” means a rating method in the large group market that bases rates on the expected costs to a health care service plan of providing covered benefits to all enrollees, including both low-risk and high-risk enrollees. Premiums may vary according to the factors in this article. (3) “Experience rated” means a rating method in the large group market under which a health care service plan calculates the premiums for a large group in whole or blended based on the group’s prior experience. (b) (1) For individual and small group market products, “geographic region” has the same meaning as in Sections 1357.512 and 1399.855. (2) For large group market products, “geographic region” means one of the following areas composed of the regions defined in Sections 1357.512 and 1399.855: (A) An area composed of regions 2, 4, 5, 6, 7, and 8, which consist of the Counties of Alameda, Contra Costa, Marin, Napa, San Mateo, Santa Clara, Solano, and Sonoma and the City and County of San Francisco. (B) An area composed of regions 1 and 3, which consist of the Counties of Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, El Dorado, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Nevada, Placer, Plumas, Sacramento, Shasta, Sierra, Siskiyou, Sutter, Tehama, Trinity, Tuolumne, Yolo, and Yuba. (C) An area composed of regions 9 and 12, which consist of the Counties of Monterey, San Benito, San Luis Obispo, Santa Barbara, Santa Cruz, and Ventura. (D) An area composed of regions 10, 11, and 14, which consist of the Counties of Fresno, Kern, Kings, Madera, Mariposa, Merced, San Joaquin, Stanislaus, and Tulare. (E) An area composed of regions 13 and 17, which consist of the Counties of Imperial, Inyo, Mono, Riverside, and San Bernardino. (F) An area composed of regions 15 and 16, which consist of the County of Los Angeles. (G) An area composed of regions 18 and 19, which consist of the Counties of Orange and San Diego. (c) “Large group health care service plan contract” means a group health care service plan contract other than a contract issued to a small employer, as defined in Section 1357, 1357.500, or 1357.600. (d) “Small group health care service plan contract” means a group health care service plan contract issued to a small employer, as defined in Section 1357, 1357.500, or 1357.600. (e) “PPACA” means Section 2794 of the federal Public Health Service Act (42 U.S.C. Sec. 300gg-94), as amended by the federal Patient Protection and Affordable Care Act (Public Law (111-148)), and any subsequent rules, regulations, or guidance issued under that section. (f) “Unreasonable rate increase” has the same meaning as that term is defined in PPACA. (Amended by Stats. 2019, Ch. 807, Sec. 2. (AB 731) Effective January 1, 2020.)
  121. 1385.02.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    This section says Article 6.2 applies to certain health care service plan contracts in California, and lists contracts it does not cover.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.02. This article shall apply to a health care service plan contract offered in the individual or group market in California, including a health care service plan contract covering dental services and a specialized health care service plan contract covering dental services. However, this article shall not apply to a nondental specialized health care service plan contract, a Medicare supplement contract subject to Article 3.5 (commencing with Section 1358.1), a health care service plan contract offered in the Medi-Cal program (Chapter 7 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code), a health care service plan contract offered in the California Major Risk Medical Insurance Program (Chapter 4 (commencing with Section 15870) of Part 3.3 of Division 9 of the Welfare and Institutions Code), a health care service plan conversion contract offered pursuant to Section 1373.6, a health care service plan contract offered to a federally eligible defined individual under Article 4.6 (commencing with Section 1366.35) or Article 10.5 (commencing with Section 1399.801), or a Mexican prepaid health plan subject to Section 1351.2. This article does not limit, impair, or interfere with the authority of the California Public Employees’ Retirement System, as set forth in Section 22794 of the Government Code and Article 6 (commencing with Section 22850) of Part 5 of Division 5 of Title 2 of the Government Code. (Amended by Stats. 2023, Ch. 557, Sec. 2. (AB 1048) Effective January 1, 2024.)
  122. 1385.026.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    The Legislature states that certain newly added sections limit public access and that information received from pharmacy benefit managers should be kept confidential.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.026. The Legislature finds and declares that Sections 19 and 29 of this act, which add Sections 1385.0011 and 1385.0021, respectively, to the Health and Safety Code, impose a limitation on the public’s right of access to the meetings of public bodies or the writings of public officials and agencies within the meaning of Section 3 of Article I of the California Constitution. Pursuant to that constitutional provision, the Legislature makes the following findings to demonstrate the interest protected by this limitation and the need for protecting that interest: To balance the public’s right to access records with the need to protect proprietary information received from pharmacy benefit managers, it is necessary that the information be kept confidential. (Added by Stats. 2025, Ch. 21, Sec. 34. (AB 116) Effective June 30, 2025.)
  123. 1385.03.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    Health care service plans must file and disclose detailed rate-review information to the department on set timelines.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.03. (a) (1) A health care service plan shall file with the department all required rate information for grandfathered individual and grandfathered and nongrandfathered group health care service plan contracts at least 120 days before implementing any rate change. (2) A health care service plan shall file with the department all required rate information for nongrandfathered individual health care service plan contracts on the earlier of the following dates: (A) One hundred days before the commencement of the annual enrollment period of the preceding policy year. (B) The date specified in the federal guidance issued pursuant to Section 154.220(b) of Title 45 of the Code of Federal Regulations. (3) For large group products that are either experience rated, in whole or blended, or community rated, a health care service plan shall file the information required by this article at least annually and shall file 120 days before any change in the methodology, factors, or assumptions that would affect the rates paid by a large group. (b) A plan shall disclose to the department all of the following for each rate filing for products in the individual, small group, community-rated segment of the large group market, and experience-rated segment, in whole or blended, in the large group market: (1) Company name and contact information. (2) Number of plan contract forms covered by the filing. (3) Plan contract form numbers covered by the filing. (4) Product type, such as a preferred provider organization or health maintenance organization. (5) Segment type. (6) Type of plan involved, such as for profit or not for profit. (7) Whether the products are opened or closed. (8) Enrollment in each plan contract and rating form. (9) Enrollee months in each plan contract form. (10) Annual rate. (11) Total earned premiums in each plan contract form. (12) Total incurred claims in each plan contract form. (13) Average rate increase initially requested. (14) Review category: initial filing for new product, filing for existing product, or resubmission. (15) Average rate of increase. (16) Effective date of rate increase. (17) Number of subscribers or enrollees affected by each plan contract form. (18) A comparison of claims cost and rate of changes over time. (19) Any changes in enrollee cost sharing over the prior year associated with the submitted rate filing. (20) Any changes in enrollee benefits over the prior year associated with the submitted rate filing. (21) The certification described in subdivision (b) of Section 1385.06. (22) Any changes in administrative costs. (23) Any other information required for rate review under PPACA. (c) A health care service plan subject to subdivision (a) shall disclose the following by geographic region for individual, grandfathered group, and nongrandfathered group contracts: (1) The plan’s overall annual medical trend factor assumptions for all benefits and by aggregate benefit category, including hospital inpatient, hospital outpatient, physician services, prescription drugs and other ancillary services, laboratory, and radiology. The plan shall also disclose integrated care management fees or other similar fees, as well as reclassification of services from one benefit category to another, such as from inpatient to outpatient. (2) Aggregated additional data that demonstrates or reasonably estimates year-to-year cost increases in specific benefit categories. (3) Information by benefit category that demonstrates the price paid compared to the price paid by the Medicare Program for the same services. (4) Variation in trend, by geographic region, if the plan serves more than one geographic region. (d) A health care service plan subject to subdivision (a) shall disclose, by geographic region for individual, grandfathered group, and nongrandfathered group contracts, the amount of the projected trend attributable to the use of services, price inflation, or fees and risk for annual plan contract trends by aggregate benefit category, such as hospital inpatient, hospital outpatient, physician services, prescription drugs and other ancillary services, laboratory, and radiology. (e) A health care service plan subject to subdivision (a) that fails to file the information required by subdivisions (c), (d), (g), and (h) for each benefit category shall also disclose the following for individual, grandfathered group, and nongrandfathered group contracts by market and by geographic region: (1) The amount spent in the prior two years, the amount projected to be spent in the current year, and the amount projected to be spent for the subsequent year for each of the following: (A) Physician services. (B) Inpatient hospital services. (C) Outpatient hospital services, including emergency department services. (D) Laboratory services. (E) Imaging and radiology services. (F) Other ancillary services. (G) Prescription drugs. (H) Integrated care management fees or other similar fees. (I) Reclassification of services from one benefit category to another, such as from inpatient to outpatient. (2) Utilization of services for the prior two years, current year, and subsequent year, as measured by the plan for the following: (A) Physician services. (B) Inpatient hospital services. (C) Outpatient hospital services, including emergency department services. (D) Laboratory services. (E) Imaging and radiology services. (F) Other ancillary services. (G) Prescription drugs. (f) A health care service plan subject to subdivision (a) shall also disclose the following aggregate data for all rate filings submitted under this section in the individual and group health care service plan markets: (1) Number and percentage of rate filings reviewed by the following: (A) Plan year. (B) Segment type. (C) Product type. (D) Number of subscribers. (E) Number of covered lives affected. (2) The plan’s average rate increase by the following categories: (A) Plan year. (B) Segment type. (C) Product type. (3) Any cost containment and quality improvement efforts since the plan’s last rate filing for the same category of health benefit plan. To the extent possible, the plan shall describe any significant new health care cost containment and quality improvement efforts and provide an estimate of potential savings together with an estimated cost or savings for the projection period. If rate filings in a prior year or years included a description of cost containment or quality improvement efforts, the plan shall document the effects of those efforts, if any, including the impact on rates and documented improvements in quality, such as reduction of readmissions, reduction of emergency room use, or other recognized measures of quality improvement. (g) For large group experience-rated, in whole or blended, and community-rated filings, the plan shall also submit the following: (1) The geographic regions used. (2) Age, including age rating factors. (3) Industry or occupation adjustments. (4) Family composition. (5) Enrollee cost sharing. (6) Covered benefits in addition to basic health care services, as defined in subdivision (b) of Section 1345, and other benefits mandated by this article. (7) The base rate or rates and the factors used to determine the base rate or rates. (8) Whether benefits, including prescription drugs, dental, and vision, are separately contracted. (9) Variations in covered benefits, including durable medical equipment, infertility, and other similar benefits. (10) Cost-sharing variations, described with actuarial value ranges and any expected impact on rates. (11) Any other factor that affects the community rating. (h) For large group filings that are experience rated, either in whole or blended, the plan shall submit the methodology for modifying the rate based on experience. (i) (1) The department may require all health care service plans to submit all rate filings to the National Association of Insurance Commissioners’ System for Electronic Rate and Form Filing (SERFF). Submission of the required rate filings to SERFF shall be deemed to be filing with the department for purposes of compliance with this section. (2) If California-specific information is required, the department may require additional schedules or documents. (j) A plan shall submit any other information required under PPACA. A plan shall also submit any other information required pursuant to a regulation adopted by the department to comply with this article. (k) (1) A plan shall respond to the department’s request for any additional information necessary for the department to complete its review of the plan’s rate filing for individual and group health care service plan contracts under this article within five business days of the department’s request or as otherwise required by the department. (2) Except as provided in paragraph (3), the department shall determine whether a plan’s rate change for individual and small group health care service plan contracts is unreasonable or not justified no later than 60 days following receipt of all the information the department requires to makes its determination. For both experience-rated, in whole or blended, and community-rated large groups, the department shall determine whether the methodology, factors, and assumptions used to determine rates are unreasonable or not justified no later than 60 days following receipt of all the information the department requires to make its determination. (3) For all nongrandfathered individual health care service plan contracts, the department shall issue a determination that the plan’s rate change is unreasonable or not justified no later than 15 days before the start of the next annual enrollment period. If a health care service plan fails to provide all the information the department requires in order for the department to make its determination, the department may determine that a plan’s rate change is unreasonable or not justified. (4) The department may contract with a consultant or consultants with expertise to assist the department in its review. Contracts entered into pursuant to the authority in this article shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Article 4 (commencing with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the Government Code, and the State Contract Act (Chapter 1 (commencing with Section 10100) of Part 2 of Division 2 of the Public Contract Code). (l) If the department determines that a plan’s rate change for individual or group health care service plan contracts is unreasonable or not justified consistent with this article, the health care service plan shall provide notice of that determination to an individual or group applicant. For experience-rated, in whole or blended, and community-rated large groups, the determination by the department shall apply to methodology, factors, and assumptions used to determine rates. The notice provided to an individual applicant shall be consistent with the notice described in subdivision (c) of Section 1389.25. The notice provided to a group applicant shall be consistent with the notice described in Section 1374.21. (m) Failure to provide the information required by subdivision (b), (c), (d), (e), (g), or (h) shall constitute an unjustified rate. (n) For purposes of this section, “policy year” has the same meaning as set forth in subdivision (g) of Section 1399.845. (o) (1) The department may adopt emergency regulations implementing this section. The department may, on a one-time basis, readopt an emergency regulation authorized by this section that is the same as, or substantially equivalent to, an emergency regulation previously adopted under this section. (2) The initial adoption of emergency regulations implementing this section and the readoption of emergency regulations authorized by this subdivision shall be deemed an emergency and necessary for the immediate preservation of the public peace, health, safety, or general welfare. The initial emergency regulations and the readoption of emergency regulations authorized by this section shall be submitted to the Office of Administrative Law for filing with the Secretary of State and each shall remain in effect for no more than 180 days, by which time final regulations may be adopted. (p) This section shall become operative on July 1, 2020. (Repealed (in Sec. 4) and added by Stats. 2019, Ch. 807, Sec. 5. (AB 731) Effective January 1, 2020. Section operative July 1, 2020, by its own provisions.)
  124. 1385.035.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    A health care service plan must show how health care cost-target changes affect its rates when rates are submitted for review, and the director must consider that impact when deciding whether a rate is unreasonable or unjustified.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.035. (a) It is the intent of the Legislature in enacting this section to ensure that enrollees and subscribers benefit from reductions in the rate of growth in health care costs as a result of the establishment of the Office of Health Care Affordability. (b) In submitting rates for review consistent with this article, a health care service plan shall demonstrate the impact of any changes in the rate of growth in health care costs resulting from the health care cost targets set pursuant to Chapter 2.6 (commencing with Section 127500) of Part 2 of Division 107. (c) In determining whether a rate is unreasonable or not justified, the director shall consider the impact on changes in health care costs as a result of the health care cost targets set pursuant to Chapter 2.6 (commencing with Section 127500) of Part 2 of Division 107. (Added by Stats. 2022, Ch. 47, Sec. 7. (SB 184) Effective June 30, 2022.)
  125. 1385.04.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    Health plans covered by this section must file required rate information with the department at least 60 days before a rate change, submit required PPACA and other department-required information, and disclose specified aggregate rate data; the department may also require SERFF submission.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.04. (a) For large group health care service plan contracts, all health plans shall file with the department at least 60 days prior to implementing any rate change all required rate information for unreasonable rate increases. This filing shall be concurrent with the written notice described in subdivision (a) of Section 1374.21. (b) For large group rate filings, health plans shall submit all information that is required by PPACA. A plan shall also submit any other information required pursuant to any regulation adopted by the department to comply with this article. (c) A health care service plan subject to subdivision (a) shall also disclose the following aggregate data for all rate filings submitted under this section in the large group health plan market: (1) Number and percentage of rate filings reviewed by the following: (A) Plan year. (B) Segment type. (C) Product type. (D) Number of subscribers. (E) Number of covered lives affected. (2) The plan’s average rate increase by the following categories: (A) Plan year. (B) Segment type. (C) Product type. (3) Any cost containment and quality improvement efforts since the plan’s last rate filing for the same category of health benefit plan. To the extent possible, the plan shall describe any significant new health care cost containment and quality improvement efforts and provide an estimate of potential savings together with an estimated cost or savings for the projection period. (d) The department may require all health care service plans to submit all rate filings to the National Association of Insurance Commissioners’ System for Electronic Rate and Form Filing (SERFF). Submission of the required rate filings to SERFF shall be deemed to be filing with the department for purposes of compliance with this section. (Added by Stats. 2010, Ch. 661, Sec. 4. (SB 1163) Effective January 1, 2011.)
  126. 1385.043.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    Health care service plans (except specialized plans) must annually report specified rate and enrollment information to the department, and the department must later present and post the reported information.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.043. (a) A health care service plan, not including a specialized health care service plan, shall annually report to the department the information described in subdivision (c) for all grandfathered and nongrandfathered products that the plan offers and sells in the individual market, including both on-exchange and off-exchange enrollment, for rates effective during the 12-month period ending January 1 of the following year. (b) A health care service plan, not including a specialized health care service plan, shall annually report to the department the information described in subdivision (c) for all grandfathered and nongrandfathered products that the plan offers and sells in the small group market, including both on-exchange and off-exchange enrollment, for products with rates effective during that 12-month period ending January 1 of the following year. (c) (1) Information on premiums, including share of premium, if applicable, average premium weighted by enrollment, and weighted average rate change. (2) Cost sharing, including deductibles, maximum out-of-pocket limit, copayments, coinsurance, and any other cost sharing for covered benefits as well as high deductible health plans. (3) (A) For nongrandfathered plans, benefits, including essential health benefits or basic health care services. (B) For grandfathered plans, basic health care services and mandates. (4) Standard and nonstandard benefit designs, including on-exchange and off-exchange nonstandard benefit designs. (5) Enrollment by actuarial value tier, product, benefit design and premiums, including both of the following: (A) Enrollment in products with zero deductibles, high deductibles as defined in this section, and deductibles between zero and high. (B) (i) Enrollment by premium. (ii) For small group products, enrollment by share of premium. (6) Trend factors as reported in individual and small group rate filings for the health care service plan, including both price and utilization, as required in Section 1385.03. (d) By October 1, 2021, and annually thereafter, a health care service plan shall submit the annual report, as described under subdivision (a), to the department in a form and manner determined by the department. (e) Beginning in 2022, the department shall annually present the information reported under this section in the meeting specified in Section 1385.045, a meeting of the Financial Solvency Standards Board, or at any other public meeting the department deems appropriate. The department also shall post the information reported under this section on its internet website no later than December 15 of each year. (f) The following definitions apply for purposes of this section: (1) “Average premium weighted by enrollment” means the following: (A) For the individual market, the average premium shall be weighted by the number of individual enrollees in the plan’s individual market during the 12-month period. (B) For the small group market, the average premium shall be weighted by the number of enrollees in each small group benefit design in the plan’s small group market during the 12-month period. (2) “Benefit design” means the cost sharing for covered benefits. (3) “High deductible” has the same meaning as defined in Section 223(c)(2)(A) of Title 26 of the United States Code. (4) “Nonstandard benefit design” means a benefit design other than the standard benefit design. (5) “Share of premium” means the share of premium paid by the enrollee on behalf of the enrollee and any dependents, not the subscriber. (6) “Standard benefit design” means the standardized products approved by the executive board of the California Health Benefit Exchange pursuant to subdivision (c) of Section 100504 of the Government Code. (g) Until January 1, 2023, a health care service plan shall not be required to report either of the following information: (1) Share of premium paid by enrollee. (2) Enrollment by benefit design, deductible, or share of premium. (h) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section by means of all-plan letters, forms, or similar instructions, without taking regulatory action until January 1, 2024. (Added by Stats. 2020, Ch. 277, Sec. 1. (AB 2118) Effective January 1, 2021.)
  127. 1385.045.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    Health care service plans must file and disclose large-group rate information, and the department must hold a public meeting every even-numbered year.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.045. (a) For large group health care service plan contracts, a health care service plan shall file with the department the weighted average rate increase for all large group benefit designs during the 12-month period ending January 1 of the following calendar year. The average shall be weighted by the number of enrollees in each large group benefit design in the plan’s large group market and adjusted to the most commonly sold large group benefit design by enrollment during the 12-month period. For the purposes of this section, the large group benefit design includes, but is not limited to, benefits such as basic health care services and prescription drugs. The large group benefit design shall not include cost sharing, including, but not limited to, deductibles, copays, and coinsurance. (b) (1) A plan shall also submit any other information required pursuant to any regulation adopted by the department to comply with this article. (2) The department shall conduct a public meeting in every even-numbered year regarding large group rates within four months of posting the aggregate information described in this section in order to permit a public discussion of the reasons for the changes in the rates, benefits, and cost sharing in the large group market. The meeting shall be held in either the Los Angeles area or the San Francisco Bay area. (c) A health care service plan subject to subdivision (a) shall also disclose the following for the aggregate rate information for the large group market submitted under this section: (1) For rates effective during the 12-month period ending January 1 of the following year, number and percentage of rate changes reviewed by the following: (A) Plan year. (B) Segment type, including whether the rate is community rated, in whole or in part. (C) Product type. (D) Number of enrollees. (E) The number of products sold that have materially different benefits, cost sharing, or other elements of benefit design. (2) For rates effective during the 12-month period ending January 1 of the following year, any factors affecting the base rate, and the actuarial basis for those factors, including all of the following: (A) Geographic region. (B) Age, including age rating factors. (C) Occupation. (D) Industry. (E) Health status factors, including, but not limited to, experience and utilization. (F) Employee, and employee and dependents, including a description of the family composition used. (G) Enrollees’ share of premiums. (H) Enrollees’ cost sharing, including cost sharing for prescription drugs. (I) Covered benefits in addition to basic health care services, as defined in Section 1345, and other benefits mandated under this article. (J) Which market segment, if any, is fully experience rated and which market segment, if any, is in part experience rated and in part community rated. (K) Any other factor that affects the rate that is not otherwise specified. (3) (A) The plan’s overall annual medical trend factor assumptions for all benefits and by aggregate benefit category, including hospital inpatient, hospital outpatient, physician services, prescription drugs and other ancillary services, laboratory, and radiology for the applicable 12-month period ending January 1 of the following year. (B) The amount of the projected trend separately attributable to the use of services, price inflation, and fees and risk for annual plan contract trends by aggregate benefit category, including hospital inpatient, hospital outpatient, physician services, prescription drugs and other ancillary services, laboratory, and radiology. (C) A comparison of the aggregate per-enrollee, per-month costs and rate of changes over the last five years for each of the following: (i) Premiums. (ii) Claims costs, if any. (iii) Administrative expenses. (iv) Taxes and fees. (D) Any changes in enrollee cost sharing over the prior year associated with the submitted rate information, including both of the following: (i) Actual copays, coinsurance, deductibles, annual out of pocket maximums, and any other cost sharing by the benefit categories determined by the department. (ii) Any aggregate changes in enrollee cost sharing over the prior years as measured by the weighted average actuarial value, weighted by the number of enrollees. (E) Any changes in enrollee benefits over the prior year, including a description of benefits added or eliminated, as well as any aggregate changes, as measured as a percentage of the aggregate claims costs, listed by the categories determined by the department. (F) Any cost containment and quality improvement efforts since the plan’s prior year’s information pursuant to this section for the same category of health benefit plan. To the extent possible, the plan shall describe any significant new health care cost containment and quality improvement efforts and provide an estimate of potential savings together with an estimated cost or savings for the projection period. (G) The number of products covered by the information that incurred the excise tax paid by the health care service plan. (4) (A) For covered prescription generic drugs excluding specialty generic drugs, prescription brand name drugs excluding specialty drugs, and prescription brand name and generic specialty drugs dispensed at a plan pharmacy, network pharmacy, or mail order pharmacy for outpatient use, all of the following shall be disclosed: (i) The percentage of the premium attributable to prescription drug costs for the prior year for each category of prescription drugs as defined in this subparagraph. (ii) The year-over-year increase, as a percentage, in per-member, per-month total health care service plan spending for each category of prescription drugs as defined in this subparagraph. (iii) The year-over-year increase in per-member, per-month costs for drug prices compared to other components of the health care premium. (iv) The specialty tier formulary list. (B) The plan shall include the percentage of the premium attributable to prescription drugs administered in a doctor’s office that are covered under the medical benefit as separate from the pharmacy benefit, if available. (C) (i) The plan shall include information on its use of a pharmacy benefit manager, if any, including which components of the prescription drug coverage described in subparagraphs (A) and (B) are managed by the pharmacy benefit manager. (ii) The plan shall also include the name or names of the pharmacy benefit manager, or managers if the plan uses more than one. (d) The information required pursuant to this section shall be submitted to the department on or before October 1, 2018, and on or before October 1 annually thereafter. Information submitted pursuant to this section is subject to Section 1385.07. (e) For the purposes of this section, a “specialty drug” is one that exceeds the threshold for a specialty drug under the Medicare Part D program (Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173)). (Amended by Stats. 2020, Ch. 370, Sec. 195. (SB 1371) Effective January 1, 2021.)
  128. 1385.046.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    An eligible large group contractholder may ask the department to review a rate change, and the plan must provide requested information quickly while the department reviews and decides whether the change is unreasonable or not justified.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.046. (a) Upon receiving notice of a rate change, a large group contractholder that has coverage that is experience rated in whole or blended and that meets the criteria in subdivision (e) may apply within 60 days to have the department review the rate change to determine whether the rate change is unreasonable or not justified, consistent with this article. (b) Upon receiving an application, the department shall notify the health care service plan of the application, and the plan shall provide the information required by the department to complete the department’s review of the proposed rate within five business days of the department’s request or as otherwise required by the department. (c) The department shall use all reasonable efforts to complete its review of the rate change within 60 days of receiving all the information the department requires to make its determination, and shall notify the health care service plan and the large group contractholder of its determination. (d) A rate change under review by the department shall not be imposed before a determination is made by the department pursuant to subdivision (c) or within 60 days following receipt by the department of all information the department requires to make its determination, whichever occurs earlier. (e) To apply for a review of a rate change for a particular group, at least one of the following shall apply: (1) The contractholder has more than 2,000 total enrollees. (2) The plan failed to provide the information required by this article or Section 1385.10. (f) To facilitate review, the department may group appeals that apply to the same health care service plan and that raise similar questions about rates, methodology, assumptions, or factors. (g) The department may contract with a consultant or consultants with expertise to assist the department in its review. Contracts entered into pursuant to the authority in this article shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Article 4 (commencing with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the Government Code, and the State Contract Act (Chapter 1 (commencing with Section 10100) of Part 2 of Division 2 of the Public Contract Code). (h) This section shall become operative on July 1, 2021. (Added by Stats. 2019, Ch. 807, Sec. 7. (AB 731) Effective January 1, 2020. Operative July 1, 2021, by its own provisions.)
  129. 1385.05.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    The department may request from a health care service plan any information required under this article or PPACA, even if a contract says otherwise.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.05. Notwithstanding any provision in a contract between a health care service plan and a provider, the department may request from a health care service plan any information required under this article or PPACA. (Added by Stats. 2010, Ch. 661, Sec. 4. (SB 1163) Effective January 1, 2011.)
  130. 1385.06.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    Rate-increase filings must be actuarially sound and include independent actuarial certification, and the plan must use an independent actuary.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.06. (a) A filing submitted under this article shall be actuarially sound. (b) (1) The plan shall contract with an independent actuary or actuaries consistent with this section. (2) A filing submitted under this article shall include a certification by an independent actuary or actuarial firm that the rate increase is reasonable or unreasonable and, if unreasonable, that the justification for the increase is based on accurate and sound actuarial assumptions and methodologies. Unless PPACA requires a certification of actuarial soundness for each large group contract, a filing submitted under Section 1385.04 shall include a certification by an independent actuary, as described in this section, that the aggregate or average rate increase is based on accurate and sound actuarial assumptions and methodologies. (3) The actuary or actuarial firm acting under paragraph (2) shall not be an affiliate or a subsidiary of, nor in any way owned or controlled by, a health care service plan or a trade association of health care service plans. A board member, director, officer, or employee of the actuary or actuarial firm shall not serve as a board member, director, or employee of a health care service plan. A board member, director, or officer of a health care service plan or a trade association of health care service plans shall not serve as a board member, director, officer, or employee of the actuary or actuarial firm. (c) Nothing in this article shall be construed to permit the director to establish the rates charged subscribers and enrollees for covered health care services. (Added by Stats. 2010, Ch. 661, Sec. 4. (SB 1163) Effective January 1, 2011.)
  131. 1385.07.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    This section makes most rate-review information public, but keeps certain contracted rates and related large-group information confidential.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.07. (a) Notwithstanding Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code, all information submitted under this article shall be made publicly available by the department except as provided in subdivision (b). (b) (1) The contracted rates between a health care service plan and a provider shall be deemed confidential information that shall not be made public by the department and are exempt from disclosure under the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code). The contracted rates between a health care service plan and a provider shall not be disclosed by a health care service plan to a large group purchaser that receives information pursuant to Section 1385.10. (2) The contracted rates between a health care service plan, including those submitted to the department pursuant to Section 1385.046, and a large group shall be deemed confidential information that shall not be made public by the department and are exempt from disclosure under the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code). Information provided to a large group purchaser pursuant to Section 1385.10 shall be deemed confidential information that shall not be made public by the department and shall be exempt from disclosure under the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code). (c) All information submitted to the department under this article shall be submitted electronically in order to facilitate review by the department and the public. (d) In addition, the department and the health care service plan shall, at a minimum, make the following information readily available to the public on their internet websites in plain language and in a manner and format specified by the department, except as provided in subdivision (b). For individual and small group health care service plan contracts, the information shall be made public for 120 days prior to the implementation of the rate increase. For large group health care service plan contracts, the information shall be made public for 60 days prior to the implementation of the rate increase. The information shall include: (1) Justifications for any unreasonable rate increases, including all information and supporting documentation as to why the rate increase is justified. (2) A plan’s overall annual medical trend factor assumptions in each rate filing for all benefits. (3) A health care service plan’s actual costs, by aggregate benefit category to include hospital inpatient, hospital outpatient, physician services, prescription drugs and other ancillary services, laboratory, and radiology. (4) The amount of the projected trend attributable to the use of services, price inflation, or fees and risk for annual plan contract trends by aggregate benefit category, such as hospital inpatient, hospital outpatient, physician services, prescription drugs and other ancillary services, laboratory, and radiology. (Amended by Stats. 2021, Ch. 615, Sec. 228. (AB 474) Effective January 1, 2022. Operative January 1, 2023, pursuant to Sec. 463 of Stats. 2021, Ch. 615.)
  132. 1385.08.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    The director may issue guidance to health care service plans about compliance, and the department must consult the Department of Insurance when doing specified implementation actions.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.08. (a) On or before July 1, 2012, the director may issue guidance to health care service plans regarding compliance with this article. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). (b) The department shall consult with the Department of Insurance in issuing guidance under subdivision (a), in adopting necessary regulations, in posting information on its Internet Web site under this article, and in taking any other action for the purpose of implementing this article. (Added by Stats. 2010, Ch. 661, Sec. 4. (SB 1163) Effective January 1, 2011.)
  133. 1385.09.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    A health care service plan contract covered by Section 1385.03 or 1385.04 must file a separate schedule showing cost savings under Section 1367.016 and the effect on rates.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.09. A health care service plan contract subject to Section 1385.03 or 1385.04 shall file a separate schedule documenting the cost savings associated with Section 1367.016 and the impact on rates. (Added by Stats. 2019, Ch. 862, Sec. 4. (AB 290) Effective January 1, 2020.)
  134. 1385.10.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    Health care service plans must give annual claims data to qualifying large group purchasers at no charge, but only in deidentified form and only when the purchaser meets the section’s requirements.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.10. (a) (1) A health care service plan shall annually provide claims data at no charge to a large group purchaser if the large group purchaser requests the information and otherwise meets the requirements of this section. (2) The health care service plan shall provide claims data that a qualified statistician has determined are deidentified so that the claims data do not identify or do not provide a reasonable basis from which to identify an individual. If the statistician is unable to determine that the data has been deidentified, then the data that cannot be deidentified shall not be provided by the health care service plan to the large group purchaser. A health care service plan may provide the claims data in an aggregated form as necessary to comply with subdivisions (e) and (f). (b) (1) As an alternative to providing claims data required pursuant to subdivision (a), the plan shall provide, at no charge to a large group purchaser, all of the following: (A) Deidentified data sufficient for the large group purchaser to calculate the cost of obtaining similar services from other health plans and evaluate cost-effectiveness by service and disease category. (B) Deidentified aggregated patient-level data on demographics, prescribing, encounters, inpatient services, outpatient services, and any other data that is comparable to what is required of the health plan to comply with risk adjustment, reinsurance, or risk corridors pursuant to the federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), and any rules, regulations, or guidance issued thereunder. (C) Deidentified aggregated patient-level data used to experience rate the large group, including diagnostic and procedure coding and costs assigned to each service that the plan has available. (2) The health care service plan shall obtain a formal determination from a qualified statistician that the data provided pursuant to this subdivision have been deidentified so that the data do not identify or do not provide a reasonable basis from which to identify an individual. If the statistician is unable to determine that the data has been deidentified, the health care service plan shall not provide the data that cannot be deidentified to the large group purchaser. The statistician shall document the formal determination in writing and shall, upon request, provide the protocol used for deidentification to the department. (c) Data provided pursuant to this section shall only be provided to a large group purchaser that meets both of the following conditions: (1) Is able to demonstrate its ability to comply with state and federal privacy laws. (2) Is a large group purchaser that is either an employer with an enrollment of greater than 1,000 covered lives and at least 500 covered lives enrolled with the health care service plan providing the information or a multiemployer trust with an enrollment of greater than 500 covered lives and at least 250 covered lives enrolled with the health care service plan providing the information. (d) Nothing in this section shall be construed to prohibit a plan and purchaser from negotiating the release of additional information not described in this section. (e) All disclosures of data to the large group purchaser made pursuant to this section shall comply with the federal Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191) and the federal Health Information Technology for Economic and Clinical Health Act, Title XIII of the federal American Recovery and Reinvestment Act of 2009 (Public Law 111-5), and implementing regulations. (f) All disclosures of data to the large group purchaser made pursuant to this section shall comply with the Confidentiality of Medical Information Act (Chapter 1 (commencing with Section 56) of Part 2.6 of Division 1 of the Civil Code). (Added by Stats. 2014, Ch. 577, Sec. 3. (SB 1182) Effective January 1, 2015.)
  135. 1385.11.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    The department may review rate filings, and it must post or report certain rate-increase comments, changes, and decisions on its website or to the Legislature.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.11. (a) Whenever it appears to the department that any person has engaged, or is about to engage, in any act or practice constituting a violation of this article, including the filing of inaccurate or unjustified rates or inaccurate or unjustified rate information, the department may review the rate filing to ensure compliance with the law. (b) The department may review other filings. (c) The department shall accept and post to its Internet Web site any public comment on a rate increase submitted to the department during the applicable period described in subdivision (d) of Section 1385.07. (d) The department shall report to the Legislature at least quarterly on all unreasonable rate filings. (e) The department shall post on its Internet Web site any changes submitted by the plan to the proposed rate increase, including any documentation submitted by the plan supporting those changes. (f) If the director makes a decision that an unreasonable rate increase is not justified or that a rate filing contains inaccurate information, the department shall post that decision on its Internet Web site. (g) Nothing in this article shall be construed to impair or impede the department’s authority to administer or enforce any other provision of this chapter. (Amended by Stats. 2016, Ch. 498, Sec. 4. (SB 908) Effective January 1, 2017.)
  136. 1385.13.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    The department must provide rate-trend data to the U.S. Secretary of Health and Human Services and, after the Exchange is created, provide the Exchange with information needed for federal compliance.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.13. The department shall do all of the following in a manner consistent with applicable federal laws, rules, and regulations: (a) Provide data to the United States Secretary of Health and Human Services on health care service plan rate trends in premium rating areas. (b) Commencing with the creation of the Exchange, provide to the Exchange such information as may be necessary to allow compliance with federal law, rules, regulations, and guidance. (Added by Stats. 2010, Ch. 661, Sec. 4. (SB 1163) Effective January 1, 2011.)
  137. 1385.14.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. )

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    Dental-service health care plans must file required rate-filing information with the department, and the department has review and rulemaking powers tied to those filings.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 6.2. Review of Rate Increases [1385.01 - 1385.14] ( Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4. ) ## 1385.14. (a) This section shall apply only to a health care service plan covering dental services and a specialized health care service plan covering dental services, as defined in Section 1374.194. (b) On or after January 1, 2025, and at least annually thereafter, a plan shall file with the department the information required by this article, as applicable, including, but not limited to, all of the following: (1) Type of plan involved, such as for profit or not for profit. (2) Product type, such as a preferred provider organization or health maintenance organization. (3) Whether the products are opened or closed. (4) Annual rate. (5) Total earned premiums in each plan contract form. (6) Total incurred claims in each plan contract form. (7) Review category: initial filing for new product, filing for existing product, or resubmission. (8) Average rate of increase. (9) Effective date of rate increase. (10) Number of subscribers or enrollees affected by each plan contract form. (11) A comparison of claims cost and rate changes over time. (12) Any changes in enrollee cost sharing over the prior year associated with the submitted rate filing. (13) Any changes in enrollee benefits over the prior year associated with the submitted rate filing. (14) Any changes in administrative costs. (15) Variation in trend, by geographic region, if the plan serves more than one geographic region. (16) The loss ratio for the plan contract as described in Section 1367.004. (17) Proposed and effective rates for all products. (18) A rating manual that outlines the methodology used in the development of the premium rates, along with a description of how rates were determined. (19) The base rate or rates and the factors used to determine the base rate or rates. (20) Trend, including overall average, and by-product, if different. (21) Any other factors affecting dental premium rates. (22) An actuarial certification signed by a qualified actuary. (23) Any other information required for the department to make its determination. (c) (1) The plan shall file with the department the required information at least 120 days before any change in the methodology, factors, or assumptions that would affect rates. (2) A plan shall respond to the department’s request for any additional information necessary for the department to complete its review of the plan’s rate filing for individual and group plan contracts within five business days of the department’s request or as otherwise required by the department. (3) If a plan fails to provide all the information the department requires in order for the department to make its determination, the department may determine that a plan’s rate change is unreasonable or not justified. (4) If the department determines that a plan’s rate change for individual or group plan contracts is unreasonable or not justified consistent with this article, the plan shall provide notice of that determination to an individual or group applicant or subscriber. (5) The department may contract with a consultant or consultants with expertise to assist the department in its review. Contracts entered into pursuant to the authority in this article shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Article 4 (commencing with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the Government Code, and the State Contract Act (Chapter 1 (commencing with Section 10100) of Part 2 of Division 2 of the Public Contract Code). (d) For all plans covering dental services, the department shall issue a determination that the plan’s rate change is unreasonable or not justified no later than 60 days following receipt of all the information the department requires to make its determination. The determination by the department shall also apply to the methodology, factors, and assumptions used to determine rates. (e) The department may review the rate filings to ensure compliance with the law, as described in Section 1385.11, excluding subdivision (c). (f) The department may require all health care service plans to submit all rate filings to the National Association of Insurance Commissioners’ System for Electronic Rate and Form Filing (SERFF). Submission of the required rate filings to SERFF shall be deemed to be filing with the department for purposes of compliance with this section. (g) (1) The department may adopt emergency regulations implementing this section. The initial adoption of emergency regulations implementing this section and the readoption of emergency regulations authorized by this subdivision shall be deemed an emergency and necessary for the immediate preservation of the public peace, health, safety, or general welfare. (2) On or before July 1, 2024, the director may issue guidance to plans regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). (3) The department shall consult with the Department of Insurance when issuing guidance on adopting necessary regulations pursuant to this subdivision. (Added by Stats. 2023, Ch. 557, Sec. 3. (AB 1048) Effective January 1, 2024.)
  138. 13850.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    Petitions must be filed by the chief petitioner(s) with the district board secretary, and the secretary may reject filing unless the signatures and filing deadlines are met.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13850. (a) Sections 100 and 104 of the Elections Code shall govern the signing of the petition and the format of the petition. (b) A petition may consist of a single instrument or separate counterparts. The chief petitioner or petitioners shall file the petition, together with all counterparts, with the secretary of the district board. The secretary shall not accept a petition for filing unless the signatures have been secured within six months of the date on which the first signature was obtained and the chief petitioner or petitioners submitted the petition to the secretary for filing within 60 days after the last signature was obtained. (Amended by Stats. 1994, Ch. 923, Sec. 136. Effective January 1, 1995.)
  139. 13851.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    The district board secretary must review a petition, verify signer information, and issue a certificate of sufficiency or notice of insufficiency. If the petition is insufficient, chief petitioners may submit a supplemental petition, and the district board must then take the required follow-up actions once a sufficient petition is filed.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13851. (a) Within 30 days after the date of filing a petition, the secretary of the district board shall cause the petition to be examined and shall prepare a certificate of sufficiency indicating whether the petition is signed by the requisite number of signers. (b) The secretary shall cause the names of the signers on the petition to be compared with the voters’ register in the office of the county clerk or registrar of voters and ascertain (i) the number of registered voters in the district, and (ii) the number of qualified signers appearing upon the petition. (c) If the certificate of the secretary shows the petition to be insufficient, the secretary shall immediately give notice by certified mail of the insufficiency to the chief petitioners. That mailed notice shall state in what amount the petition is insufficient. Within 15 days after the date of the notice of insufficiency, the chief petitioners may file with the secretary a supplemental petition bearing additional signatures. (d) Within 10 days after the date of filing a supplemental petition, the secretary shall examine the supplemental petition and certify in writing the results of his or her examination. (e) The secretary shall sign and date a certificate of sufficiency. That certificate shall also state the minimum signature requirements for a sufficient petition and show the results of the secretary’s examination. The secretary shall mail a copy of the certificate of sufficiency to the chief petitioners. (f) Once the chief petitioners have filed a sufficient petition, the district board shall take the actions required pursuant to Section 13845, 13846, or 13848. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  140. 13852.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    Vacancies on the district board must be filled under Government Code Section 1779 for appointed members and Section 1780 for elected members.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13852. (a) Any vacancy in the office of a member appointed to the district board shall be filled pursuant to Section 1779 of the Government Code. (b) Any vacancy in the office of a member elected to the district board shall be filled pursuant to Section 1780 of the Government Code. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  141. 13853.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    The district board must meet and elect its officers within 60 days after initial election or appointment, and after each general or unopposed district election.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13853. (a) Within 60 days after their initial election or appointment and after each general district election or unopposed election, the district board shall meet and elect its officers. The officers of a district board are a president, a vice president, and a secretary or clerk. (b) The secretary or clerk may be a member of the district board. He or she may receive compensation set by the district board which shall be in lieu of any other compensation to which he or she may be entitled as a member of the district board. The district board may employ a clerk to perform the duties of the secretary. (c) A district board may create additional officers and elect members to those positions, provided that no member of a district board shall hold more than one office. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  142. 13854.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    The county treasurer normally serves as district treasurer without compensation, unless the district board appoints another district treasurer by resolution.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13854. (a) Except as provided in subdivision (b), the county treasurer of the principal county shall act as the district treasurer and shall receive no compensation for the receipt and disbursement of money of the district. (b) The district board may adopt a resolution appointing a district treasurer other than the county treasurer and defining the duties and compensation of the office. The district treasurer, or any other person authorized by the district board, shall draw checks or warrants to pay any demands which have been audited and approved in the manner prescribed by the district board. (c) If the district board adopts the resolution provided by subdivision (b), the district treasurer and any other person designated by the district board shall give bonds to the district conditioned for the faithful performance of their duties. The amount of each bond shall be at least one hundred thousand dollars ($100,000) or 10 percent of the total amount of the district’s final budget for the preceding fiscal year, whichever is greater. The district board shall pay the premiums on the bonds. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  143. 13855.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    A district board must meet at least once every three months, and its meetings are subject to the Ralph M. Brown Act.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13855. A district board shall meet at least once every three months. Meetings of the board are subject to the provisions of the Ralph M. Brown Act, (Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of the Government Code). (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  144. 13856.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    The district board needs a majority quorum, may act only by ordinance, resolution, or motion, and usually needs a recorded majority vote of the total membership for each action.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13856. (a) A majority of the district board shall constitute a quorum for the transaction of business. (b) The district board shall act only by ordinance, resolution, or motion. Except as specifically provided to the contrary in this part, a recorded vote by a majority of the total membership of the district board is required on each action. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  145. 13857.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    District board members may be paid up to $100 per meeting, with a monthly cap of six paid meetings. If the district pays for more than four meetings in a month, the board must adopt an annual written policy explaining why that is necessary.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 4. Existing Board of Directors and Officers [13840 - 13857] ( Chapter 4 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13857. (a) Subject to subdivision (b), each member of the district board may receive compensation in an amount set by the district board not to exceed one hundred dollars ($100) for attending each meeting of the district board. The number of meetings for which a member of the board of directors may receive compensation shall not exceed six meetings in any calendar month. Commencing January 1, 2019, if the district compensates its members for more than four meetings in a calendar month, the district board shall annually adopt a written policy describing, based on a finding supported by substantial evidence, why more than four meetings per month are necessary for the effective operation of the district. (b) The district board, by ordinance adopted pursuant to Chapter 2 (commencing with Section 20200) of Division 10 of the Water Code, may increase the compensation received by the district board members above the amount prescribed by subdivision (a). (c) For purposes of this section, the determination of whether a director’s activities on any specific day are compensable shall be made pursuant to Article 2.3 (commencing with Section 53232) of Chapter 2 of Part 1 of Division 2 of Title 5 of the Government Code. (Amended by Stats. 2018, Ch. 170, Sec. 2. (AB 2329) Effective January 1, 2019.)
  146. 1386.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7. Discipline [1386 - 1389] ( Article 7 added by Stats. 1975, Ch. 941. )

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    The director may discipline a health care service plan’s license, including suspension, revocation, or administrative penalties, and may impose a corrective action plan.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7. Discipline [1386 - 1389] ( Article 7 added by Stats. 1975, Ch. 941. ) ## 1386. (a) The director may, after appropriate notice and opportunity for a hearing, by order suspend or revoke any license issued under this chapter to a health care service plan or assess administrative penalties if the director determines that the licensee has committed any of the acts or omissions constituting grounds for disciplinary action. (b) The following acts or omissions constitute grounds for disciplinary action by the director: (1) The plan is operating at variance with the basic organizational documents as filed pursuant to Section 1351 or 1352, or with its published plan, or in any manner contrary to that described in, and reasonably inferred from, the plan as contained in its application for licensure and annual report, or any modification thereof, unless amendments allowing the variation have been submitted to, and approved by, the director. (2) The plan has issued, or permits others to use, evidence of coverage or uses a schedule of charges for health care services that do not comply with those published in the latest evidence of coverage found unobjectionable by the director. (3) The plan does not provide basic health care services to its enrollees and subscribers as set forth in the evidence of coverage. This subdivision shall not apply to specialized health care service plan contracts. (4) The plan is no longer able to meet the standards set forth in Article 5 (commencing with Section 1367). (5) The continued operation of the plan will constitute a substantial risk to its subscribers and enrollees. (6) The plan has violated or attempted to violate, or conspired to violate, directly or indirectly, or assisted in or abetted a violation or conspiracy to violate any provision of this chapter, any rule or regulation adopted by the director pursuant to this chapter, or any order issued by the director pursuant to this chapter. (7) The plan has engaged in any conduct that constitutes fraud or dishonest dealing or unfair competition, as defined by Section 17200 of the Business and Professions Code. (8) The plan has permitted, or aided or abetted any violation by an employee or contractor who is a holder of any certificate, license, permit, registration, or exemption issued pursuant to the Business and Professions Code or this code that would constitute grounds for discipline against the certificate, license, permit, registration, or exemption. (9) The plan has aided or abetted or permitted the commission of any illegal act. (10) The engagement of a person as an officer, director, employee, associate, or provider of the plan contrary to the provisions of an order issued by the director pursuant to subdivision (e) of this section or subdivision (d) of Section 1388. (11) The engagement of a person as a solicitor or supervisor of solicitation contrary to the provisions of an order issued by the director pursuant to Section 1388. (12) The plan, its management company, or any other affiliate of the plan, or any controlling person, officer, director, or other person occupying a principal management or supervisory position in the plan, management company, or affiliate, has been convicted of or pleaded nolo contendere to a crime, or committed any act involving dishonesty, fraud, or deceit, which crime or act is substantially related to the qualifications, functions, or duties of a person engaged in business in accordance with this chapter. The director may revoke or deny a license hereunder irrespective of a subsequent order under the provisions of Section 1203.4 of the Penal Code. (13) The plan violates Section 510, 2056, or 2056.1 of the Business and Professions Code or Section 1375.7. (14) The plan has been subject to a final disciplinary action taken by this state, another state, an agency of the federal government, or another country for any act or omission that would constitute a violation of this chapter. (15) The plan violates the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code). (16) The plan violates Section 806 of the Military and Veterans Code. (17) The plan violates Section 1262.8. (18) The plan violates Chapter 8.5 (commencing with Section 127671) of Part 2 of Division 107, including the data submission requirements of that chapter. (19) The plan fails to comply with a corrective action plan in a timely manner, consistent with Section 1380, this section, or other provisions of this chapter. (20) The plan fails to respond fully or timely, or both, to a duly authorized request for production of records. (c) In addition to the authority to conduct an onsite medical survey and prepare a corrective plan pursuant to Section 1380 and to conduct an assessment of the health care service plan’s financial health, including, but not limited to, identification of the plan’s available reserves, the director may impose a corrective action plan to require future compliance by the health care service plan with any other provision of this chapter. Failure by the health care service plan to comply with a corrective action plan imposed pursuant to this subdivision in a timely manner appropriate for rectifying noncompliance shall be monitored by the department through medical surveys, financial examinations, or other means necessary to assure timely compliance. (d) (1) When assessing administrative penalties against a health plan, or civil penalties pursuant to Section 1387, the director shall determine the appropriate amount of the penalty for each violation of this chapter based upon one or more factors, as applicable, including, but not limited to, the following: (A) The nature, scope, and gravity of the violation. (B) The good or bad faith of the plan. (C) The plan’s history of violations. (D) The willfulness of the violation. (E) The nature and extent to which the plan cooperated with the department’s investigation. (F) The nature and extent to which the plan aggravated or mitigated any injury or damage caused by the violation. (G) The nature and extent to which the plan has taken corrective action to ensure the violation will not recur. (H) The financial status of the plan, including reserves, financial solvency, revenues in excess of expenditures and other factors relating to the financial status of the domestic corporation and any parent company, subsidiary, affiliate, or other financially connected entity, if any. (I) The financial cost of the health care service that was denied, delayed, or modified, including whether the penalty is commensurate with or exceeds the avoided cost based on the number of enrollees estimated to be affected. (J) Whether the violation is an isolated incident. (2) The amount of the penalty shall also take into account one or more of the following: (A) The number of enrollees estimated to be affected. (B) The frequency of the violation based on the number of days for a continuous violation or the estimated number of incidents with potential harm to enrollees. (C) The severity of the potential harm in terms of loss of life, loss of health, or financial harm to the enrollee. (D) The amount of the penalty necessary to deter similar violations in the future. (e) (1) The director may prohibit any person from serving as an officer, director, employee, associate, or provider of any plan or solicitor firm, or of any management company of any plan, or as a solicitor, if either of the following applies: (A) The prohibition is in the public interest and the person has committed, caused, participated in, or had knowledge of a violation of this chapter by a plan, management company, or solicitor firm. (B) The person was an officer, director, employee, associate, or provider of a plan or of a management company or solicitor firm of any plan whose license has been suspended or revoked pursuant to this section and the person had knowledge of, or participated in, any of the prohibited acts for which the license was suspended or revoked. (2) A proceeding for the issuance of an order under this subdivision may be included with a proceeding against a plan under this section or may constitute a separate proceeding, subject in either case to subdivision (f). (f) A proceeding under this section shall be subject to appropriate notice to, and the opportunity for a hearing with regard to, the person affected in accordance with subdivision (a) of Section 1397. (Amended by Stats. 2024, Ch. 760, Sec. 3. (AB 3221) Effective January 1, 2025.)
  147. 13860.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    A district has perpetual succession.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13860. A district has perpetual succession. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  148. 13861.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    A district may exercise the rights and powers needed to carry out this part, including suing, acquiring and managing property, hiring employees and counsel, making contracts, adopting a seal and ordinances, setting rules, entering joint powers agreements, and providing insurance.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13861. A district shall have and may exercise all rights and powers, expressed or implied, necessary to carry out the purposes and intent of this part, including, but not limited to, the following powers: (a) To sue and be sued. (b) To acquire any property, including water facilities for providing fire protection, within the district by any means, to hold, manage, occupy, dispose of, convey and encumber the property, and to create a leasehold interest in the property for the benefit of the district. (c) To acquire by eminent domain any property necessary to carry out any of its powers or functions. (d) To appoint necessary employees, to define their qualifications and duties, and to provide a pay schedule for performance of their duties. (e) To employ counsel. (f) To enter into and perform all necessary contracts pursuant to Article 53 (commencing with Section 20810) of Part 3 of Division 2 of the Public Contract Code. (g) To adopt a seal and alter it at pleasure. (h) To adopt ordinances following the procedures of Article 7 (commencing with Section 25120) of Chapter 1 of Part 2 of Division 2 of Title 3 of the Government Code. (i) To establish and enforce rules and regulations for the administration, operation, and maintenance of the services listed in Section 13862. (j) To enter joint powers agreements pursuant to Chapter 5 (commencing with Section 6500) of Division 7 of Title 1 of the Government Code. (k) To provide insurance pursuant to Part 6 (commencing with Section 989) of Division 3.6 of Title 1 of the Government Code. (Amended by Stats. 1988, Ch. 465, Sec. 7. Effective August 22, 1988.)
  149. 13862.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A district has the power to provide fire protection and related emergency services.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13862. A district shall have the power to provide the following services: (a) Fire protection services. (b) Rescue services. (c) Emergency medical services. (d) Hazardous material emergency response services. (e) Ambulance services, pursuant to Division 2.5 (commencing with Section 1797). (f) Any other services relating to the protection of lives and property. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  150. 13863.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A district may enter into mutual aid agreements with specified public entities and certain private or tribal fire departments. The covered firm, corporation, tribal entity, and their employees have the same civil-damages immunity as the district and its employees, except for acts or omissions on property under their control.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13863. (a) A district may enter into mutual aid agreements with any federal or state agency, any city, county, city and county, special district, or federally recognized Indian tribe. (b) A district may also enter into mutual aid agreements with any private firm, corporation, or federally recognized Indian tribe that maintains a full-time fire department. The firm, corporation, or federally recognized Indian tribe, or any of its employees, shall have the same immunity from liability for civil damages on account of personal injury to or death of any person or damage to property resulting from acts or omissions of its fire department personnel in the performance of the provisions of the mutual aid agreement as is provided by law for the district and its employees, except when the act or omission occurs on property under the control of the firm, corporation, or federally recognized Indian tribe. (Amended by Stats. 1998, Ch. 17, Sec. 1. Effective April 14, 1998.)
  151. 13864.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A district may lease or rent property from an employee, including vehicles or equipment.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13864. A district may lease or rent any property from an employee, including but not limited to, vehicles or equipment. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  152. 13865.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A district may join a local, state, or national group or association that promotes preserving life and property from fire and other disasters.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13865. A district may join any local, state, or national group or association which promotes the preservation of life and property from the hazards of fire and other disasters. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  153. 13866.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A district may authorize its directors and employees to attend professional or vocational meetings and pay their actual and necessary travel and incidental expenses while on official business.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13866. A district may authorize its directors and employees to attend professional or vocational meetings and pay their actual and necessary traveling and incidental expenses while on official business. Reimbursement for these expenses is subject to Sections 53232.2 and 53232.3 of the Government Code. (Amended by Stats. 2005, Ch. 700, Sec. 15. Effective January 1, 2006.)
  154. 13867.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    Equipment acquired for fire protection purposes must conform to the standardization rules in Article 1 of Chapter 2 of Part 1.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13867. The acquisition of any equipment for fire protection purposes shall conform to the standardization provisions of Article 1 (commencing with Section 13025) of Chapter 2 of Part 1. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  155. 13868.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A district board must keep a record of all its acts, including financial transactions. A district may destroy a record under the referenced Government Code chapter.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13868. (a) A district board shall keep a record of all its acts, including its financial transactions. (b) A district may destroy a record pursuant to Chapter 7 (commencing with Section 60200) of Division 1 of Title 6 of the Government Code. (Amended by Stats. 2005, Ch. 158, Sec. 24. Effective January 1, 2006.)
  156. 13869.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A district may adopt a fire prevention code by reference, and for that purpose the district board is treated as a legislative body and the district as a local agency.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13869. A district may adopt a fire prevention code by reference pursuant to Article 2 (commencing with Section 50022) of Chapter 1 of Part 1 of Division 1 of Title 5 of the Government Code. For that purpose, the district board shall be deemed a legislative body and the district shall be deemed a local agency. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  157. 13869.7.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    Fire protection districts may adopt stricter fire and panic safety building standards, but local ordinances must be shared, may be reviewed by the local legislative body, and are not effective until ratified.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13869.7. (a) Any fire protection district organized pursuant to Part 2.7 (commencing with Section 13800) of Division 12 may adopt building standards relating to fire and panic safety that are more stringent than those building standards adopted by the State Fire Marshal and contained in the California Building Standards Code. For these purposes, the district board shall be deemed a legislative body and the district shall be deemed a local agency. Any changes or modifications that are more stringent than the requirements published in the California Building Standards Code relating to fire and panic safety shall be subject to subdivision (b) of Section 18941.5. (b) Any fire protection district that proposes to adopt an ordinance pursuant to this section shall, not less than 30 days prior to noticing a proposed ordinance for public hearing, provide a copy of that ordinance, together with the adopted findings made pursuant to subdivision (a), to the city, county, or city and county where the ordinance will apply. The city, county, or city and county, may provide the district with written comments, which shall become part of the fire protection district’s public hearing record. (c) The fire protection district shall transmit the adopted ordinance to the city, county, or city and county where the ordinance will apply. The legislative body of the city, county, or city and county, may ratify, modify, or deny an adopted ordinance and transmit its determination to the district within 15 days of the determination. Any modification or denial of an adopted ordinance shall include a written statement describing the reasons for any modifications or denial. No ordinance adopted by the district shall be effective until ratification by the city, county, or city and county where the ordinance will apply. Upon ratification of an adopted ordinance, the city, county, or city and county, shall file a copy of the findings of the district, and any findings of the city, county, or city and county, together with the adopted ordinance expressly marked and identified to which each finding refers, with the Department of Housing and Community Development. (d) Nothing in this section shall authorize a district to mandate, nor prohibit a district from mandating, the installation of residential fire sprinkler systems within newly constructed dwelling units or in new additions to existing dwelling units, including, but not limited to, manufactured homes as defined in Section 18007. (e) Nothing in this section shall authorize a district to mandate, nor prohibit a district from mandating, the retrofitting of existing dwelling units for the installation of residential fire sprinkler systems, including, but not limited to, manufactured homes as defined in Section 18007. (f) Nothing in this section shall apply in any manner to litigation filed prior to January 1, 1991, regarding an ordinance or regulation which mandates the installation of residential fire sprinkler systems within newly constructed dwelling units or in new additions to existing dwelling units. (g) This section shall not apply to fire and panic safety requirements for the public schools adopted by the State Fire Marshal pursuant to Section 13143. (h) (1) A city, county, or city and county that ratifies an ordinance relating to fire and panic safety pursuant to this section shall delegate the enforcement of the ordinance to either of the following: (A) The chief of the fire protection district that adopted the ordinance, or his or her authorized representative. (B) The chief building official of the city, county, or city and county, or his or her authorized representative. (2) Any fee charged pursuant to the enforcement authority of this subdivision shall not exceed the estimated reasonable cost of providing the service for which the fee is charged, pursuant to Section 66014 of the Government Code. (Amended by Stats. 1993, Ch. 906, Sec. 13. Effective October 8, 1993. Operative January 1, 1994, by Sec. 24 of Ch. 906.)
  158. 1387.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7. Discipline [1386 - 1389] ( Article 7 added by Stats. 1975, Ch. 941. )

    Verify source ↗

    People who violate this chapter or related rules/orders can be hit with a civil penalty up to $25,000 per violation.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7. Discipline [1386 - 1389] ( Article 7 added by Stats. 1975, Ch. 941. ) ## 1387. (a) (1) A person who violates a provision of this chapter, or who violates a rule or order adopted or issued pursuant to this chapter, shall be liable for a civil penalty of not more than twenty-five thousand dollars ($25,000) for each violation, which shall be assessed and recovered in a civil action brought in the name of the people of the State of California by the director in any court of competent jurisdiction. (2) In assessing a civil penalty, the director shall determine the appropriate amount after considering one or more factors enumerated in subdivision (d) of Section 1386, as applicable. (b) As applied to the civil penalties for acts in violation of this chapter, the remedies provided by this section and by other sections of this chapter are not exclusive, and may be sought and employed in any combination to enforce this chapter. (c) An action shall not be maintained to enforce any liability created under subdivision (a), unless brought before the expiration of four years after the act or transaction constituting the violation. (d) Commencing January 1, 2028, and every five years thereafter, the penalty amount specified in this section shall be adjusted based on the average rate of change in premium rates for the individual and small group markets, and weighted by enrollment, since the previous adjustment. (Amended by Stats. 2022, Ch. 985, Sec. 5. (SB 858) Effective January 1, 2023.)
  159. 13870.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    A district board or its authorized representative may order a fire or life hazard corrected or eliminated, and a person affected by such an order may request a hearing and review within 10 days if strict compliance would cause undue hardship.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13870. (a) Notwithstanding any other provision of law, a district board or its authorized representative may issue a written order to correct or eliminate a fire hazard or life hazard. (b) Any person who has been ordered to immediately correct or eliminate a fire hazard or life hazard pursuant to subdivision (a) and who believes that strict compliance with the order would cause undue hardship may, within 10 days, present a written request to the district board requesting a hearing on and a review of the order. The request shall state the reasons for making the request. (c) Within 30 days of the receipt of a written request pursuant to subdivision (b), the district board or its authorized representative shall hold a hearing. The board may modify, vacate, or affirm the order. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  160. 13871.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    District citations for fire-code or ordinance violations may be processed under Penal Code section 17(d); failing to correct a fire or life hazard after a written district order, or falsely personating district officials, is a misdemeanor.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13871. (a) Any citation issued by a district for violation of a fire prevention code or a district ordinance may be processed pursuant to subdivision (d) of Section 17 of the Penal Code. (b) Every person who fails or refuses to correct or eliminate a fire or life hazard after written order of a district board or its authorized representative is guilty of a misdemeanor. (c) Every person who falsely personates a member of a district board or an officer or employee of a district is guilty of a misdemeanor. (d) Every misdemeanor is punishable pursuant to Section 19 of the Penal Code. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  161. 13872.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    A district may authorize its fire chief, by ordinance, to issue citations for the misdemeanors listed in Section 13871.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13872. A district may, by ordinance, authorize its fire chief, or his or her duly authorized representative, to issue citations for the misdemeanors specified in Section 13871. The provisions of Chapter 5C (commencing with Section 853.5) of Title 4 of Part 2 of the Penal Code shall apply. (Amended by Stats. 2001, Ch. 176, Sec. 40. Effective January 1, 2002.)
  162. 13872.5.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A city, city and county, or county fire chief, or an authorized representative, may issue orders and take related hearing actions to correct or eliminate fire or life hazards, and may issue citations when authorized by ordinance.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13872.5. The fire chief of a city, city and county, or county fire department, or his or her authorized representative, has the same authority as specified in Sections 13870 to 13872, inclusive, to issue a written order to correct or eliminate a fire hazard or life hazard, hold hearings and modify, vacate, or affirm those orders, and issue citations if so authorized by ordinance of the city, city and county, or county. This section does not limit or affect any authority of a fire chief or authorized representative of a fire chief under any local ordinance. (Added by Stats. 1988, Ch. 1589, Sec. 3.)
  163. 13873.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    District employees have peace officer powers when they are engaged in fire prevention, fire suppression, and protecting life and property.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13873. Employees of a district shall have the powers of peace officers while engaged in the prevention and suppression of fires and the protection and preservation of life and property, including, but not limited to, actions associated with rescue services, emergency medical services, hazardous material emergency response services, and ambulance services. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  164. 13874.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    If a district board has adopted open-fire regulations, no person may burn any material without a permit, and a district may not issue a permit for material that would not be allowed by certain air or other agencies.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13874. If a district board has adopted regulations for the control of open fires, no person shall burn any material without a permit. A district shall not issue a permit to burn any material which would not be permitted by an air pollution control district or an air quality management district, or any other state or federal agency. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  165. 13875.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    A district may prepare and share information and run educational programs for fire prevention, reducing life hazards, and medical emergency preparedness.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13875. A district may prepare and disseminate information and operate educational programs, including, but not limited to, those which help to prevent fire, eliminate life hazards, and prepare for medical emergencies. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  166. 13876.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    A district board may adopt a resolution to change the district’s name, and it must file a copy within 10 days after adoption.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13876. A district board may adopt a resolution to change the name of the district. The resolution shall comply with the requirements of Chapter 23 (commencing with Section 7530) of Division 7 of Title 1 of the Government Code. Within 10 days of its adoption, the district board shall file a copy of the resolution with the county clerk, and the board of supervisors and the local agency formation commission of each county in which the district is located. (Amended by Stats. 1998, Ch. 829, Sec. 40. Effective January 1, 1999.)
  167. 13877.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    A district board may allow vehicles, apparatus, or equipment to be used outside the district, on any terms and conditions it sets.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13877. A district board may authorize the use of any vehicle, apparatus, or equipment outside the district, subject to any terms and conditions it prescribes. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  168. 13878.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    A district may contract to provide district services outside its boundaries, and the contract must require payment in advance.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13878. A district may contract with any person or public agency to provide district services to territory which is outside the district. A contract shall provide for payment in advance. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  169. 13879.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    A district board may abate hazardous weeds and rubbish under Part 5, and for that purpose is treated as a board of supervisors; district employees are treated as the persons designated by Section 14890.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 5. General Powers and Duties [13860 - 13879] ( Chapter 5 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13879. A district board may abate hazardous weeds and rubbish pursuant to Part 5 (commencing with Section 14875). For that purpose, the district board shall be deemed to be a “board of supervisors” and district employees shall be deemed to be the “persons” designated by Section 14890. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  170. 1388.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7. Discipline [1386 - 1389] ( Article 7 added by Stats. 1975, Ch. 941. )

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    The director may discipline a solicitor or solicitor firm by censure, suspension up to 24 months, a bar, or administrative penalties if disciplinary grounds are found.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7. Discipline [1386 - 1389] ( Article 7 added by Stats. 1975, Ch. 941. ) ## 1388. (a) The director may, after appropriate notice and opportunity for hearing, by order, censure a person acting as a solicitor or solicitor firm, or suspend for a period not exceeding 24 months or bar a person from operating as a solicitor or solicitor firm, or assess administrative penalties against a person acting as a solicitor or solicitor firm if the director determines that the person has committed any of the acts or omissions constituting grounds for disciplinary action. (b) The following acts or omissions constitute grounds for disciplinary action by the director: (1) The continued operation of the solicitor or solicitor firm in a manner that may constitute a substantial risk to a plan or subscribers and enrollees. (2) The solicitor or solicitor firm has violated or attempted to violate, or conspired to violate, directly or indirectly, or assisted in or abetted a violation or conspiracy to violate any provision of this chapter, any rule or regulation adopted by the director pursuant to the chapter, or any order issued by the director pursuant to this chapter. (3) The solicitor or solicitor firm has engaged in any conduct that constitutes fraud or dishonest dealing or unfair competition, as defined by Section 17200 of the Business and Professions Code. (4) The engagement of a person as an officer, director, employee, or associate of the solicitor firm contrary to the provisions of an order issued by the director pursuant to subdivision (d) of this section or subdivision (c) of Section 1386. (5) The solicitor or solicitor firm, or its management company, or any other affiliate of the solicitor firm, or any controlling person, officer, director, or other person occupying a principal management or supervisory position in that solicitor firm, management company, or affiliate, has been convicted or pleaded nolo contendere to a crime, or committed any act involving dishonesty, fraud, or deceit, which crime or act is substantially related to the qualifications, functions, or duties of a person engaged in business in accordance with the provisions of this chapter. The director may issue an order hereunder irrespective of a subsequent order under the provisions of Section 1203.4 of the Penal Code. (c) The director shall notify plans of any order issued pursuant to subdivision (a) which suspends or bars a person from engaging in operations as a solicitor or solicitor firm. It shall be unlawful for any plan, after receipt of notice of the order, to receive any new subscribers or enrollees through that person or to otherwise utilize any solicitation services of that person in violation thereof. (d) (1) The director may prohibit any person from serving as an officer, director, employee, or associate of any plan or solicitor firm, or as a solicitor, if that person was an officer, director, employee, or associate of a solicitor firm that has been the subject of an order of suspension or bar from engaging in operations as a solicitor firm pursuant to this section and that person had knowledge of, or participated in, any of the prohibited acts for which the order was issued. (2) A proceeding for the issuance of an order under this subdivision may be included with a proceeding against a solicitor firm under this section or may constitute a separate proceeding, subject in either case to subdivision (e). (e) A proceeding for the issuance of an order under this section shall be subject to appropriate notice to, and the opportunity for a hearing with regard to, the person affected in accordance with subdivision (a) of Section 1397. (Amended by Stats. 1999, Ch. 525, Sec. 134. Effective January 1, 2000. Operative July 1, 2000, or sooner, by Sec. 214 of Ch. 525.)
  171. 13885.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 6. Elections [13885 - 13887] ( Chapter 6 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    Districts are subject to the Uniform District Election Law, unless this part says otherwise.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 6. Elections [13885 - 13887] ( Chapter 6 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13885. Except as otherwise provided in this part, districts are subject to the Uniform District Election Law, Part 4 (commencing with Section 10500) of Division 10 of the Elections Code. (Amended by Stats. 1994, Ch. 923, Sec. 137. Effective January 1, 1995.)
  172. 13886.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 6. Elections [13885 - 13887] ( Chapter 6 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    A district board may require its board-member election to be held on the same day as the statewide general election.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 6. Elections [13885 - 13887] ( Chapter 6 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13886. A district board may require that its election of district board members be held on the same day as the statewide general election pursuant to Section 10404 of the Elections Code. (Amended by Stats. 1994, Ch. 923, Sec. 138. Effective January 1, 1995.)
  173. 13887.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 6. Elections [13885 - 13887] ( Chapter 6 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    This section assigns election costs for district matters to the county or district depending on the result and type of election.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 6. Elections [13885 - 13887] ( Chapter 6 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13887. The expense of an election on the question of the formation of a district shall be paid by the county if the proposition fails. If the formation is approved, the expense shall be a charge against the district and repaid to the county from the first moneys collected by the district. The expense of all other elections shall be a charge against the district. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  174. 1389.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7. Discipline [1386 - 1389] ( Article 7 added by Stats. 1975, Ch. 941. )

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    Certain people may ask the director to reinstate a revoked or long-suspended license, or to reduce a long suspension/bar order, but petitions cannot be considered if the person is under a criminal sentence for related violations.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7. Discipline [1386 - 1389] ( Article 7 added by Stats. 1975, Ch. 941. ) ## 1389. (a) A person whose license has been revoked, or suspended for more than one year, may petition the director to reinstate the license as provided by Section 11522 of the Government Code. No petition may be considered if the petitioner is under criminal sentence for a violation of this chapter, or any offense which would constitute grounds for discipline, or denial of licensure under this chapter, including any period of probation or parole. (b) A person who is barred, or suspended for more than one year, from acting as a solicitor or solicitor firm pursuant to Section 1388, or who is subject to an order, pursuant to subdivision (c) of Section 1386 or subdivision (d) of Section 1388, which by its terms is effective for more than one year, may petition the director to reduce by order such penalty in a manner generally consistent with the provisions of Section 11522 of the Government Code. No petition may be considered if the petitioner is under criminal sentence for a violation of this chapter, or any offense which would constitute grounds for discipline under this chapter, including any period of probation or parole. (c) The petition for restoration shall be in the form prescribed by the director and the director may condition the granting of such petition upon such additional information and undertakings as the director may require in order to determine whether such person, if restored, would engage in business in full compliance with the objectives and provisions of this chapter and the rules and regulations adopted by the director pursuant to this chapter. (d) The director may, by rule, prescribe a fee not to exceed five hundred dollars ($500) for the filing of a petition for restoration pursuant to this section. In addition, the director may condition the granting of such a petition to a plan upon payment of the assessment due and unpaid pursuant to subdivision (b) of Section 1356 as of the 15th day of December occurring within the preceding 12-calendar months and, if the plan’s suspension or revocation was in effect for more than 12 months, upon the filing of a new plan application and the payment of the fee prescribed by subdivision (a) of Section 1356. (Amended by Stats. 1999, Ch. 525, Sec. 135. Effective January 1, 2000. Operative July 1, 2000, or sooner, by Sec. 214 of Ch. 525.)
  175. 1389.1.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7.5. Underwriting Practices [1389.1 - 1389.8] ( Article 7.5 added by Stats. 1993, Ch. 1210, Sec. 3. )

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    The director may not approve a plan contract unless the application meets specific underwriting and notice requirements.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7.5. Underwriting Practices [1389.1 - 1389.8] ( Article 7.5 added by Stats. 1993, Ch. 1210, Sec. 3. ) ## 1389.1. (a) The director shall not approve any plan contract unless the director finds that the application conforms to both of the following requirements: (1) All applications for coverage which include health-related questions shall contain clear and unambiguous questions designed to ascertain the health condition or history of the applicant. (2) The application questions related to an applicant’s health shall be based on medical information that is reasonable and necessary for medical underwriting purposes. The application shall include a prominently displayed notice that shall read: “California law prohibits an HIV test from being required or used by health care service plans as a condition of obtaining coverage.” (b) Nothing in this section shall authorize the director to establish or require a single or standard application form for application questions. (Amended by Stats. 1999, Ch. 525, Sec. 136. Effective January 1, 2000. Operative July 1, 2000, or sooner, by Sec. 214 of Ch. 525.)
  176. 1389.2.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7.5. Underwriting Practices [1389.1 - 1389.8] ( Article 7.5 added by Stats. 1993, Ch. 1210, Sec. 3. )

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    At the director’s request, a health care service plan must provide a written statement explaining the actuarial basis for a medical underwriting decision.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7.5. Underwriting Practices [1389.1 - 1389.8] ( Article 7.5 added by Stats. 1993, Ch. 1210, Sec. 3. ) ## 1389.2. At the request of the director, a health care service plan shall provide a written statement of the actuarial basis for any medical underwriting decision on any application form, or contract issued or delivered to, or denied a resident of this state. (Amended by Stats. 1999, Ch. 525, Sec. 137. Effective January 1, 2000. Operative July 1, 2000, or sooner, by Sec. 214 of Ch. 525.)
  177. 1389.21.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7.5. Underwriting Practices [1389.1 - 1389.8] ( Article 7.5 added by Stats. 1993, Ch. 1210, Sec. 3. )

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    A health care service plan generally cannot rescind or limit a covered plan contract unless it can show fraud or intentional material misrepresentation; after 24 months, it also cannot rescind, cancel, limit, or raise premiums for application-form omissions or inaccuracies.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7.5. Underwriting Practices [1389.1 - 1389.8] ( Article 7.5 added by Stats. 1993, Ch. 1210, Sec. 3. ) ## 1389.21. (a) A health care service plan shall not rescind a plan contract, or limit any provisions of a plan contract, once an enrollee is covered under the contract unless the plan can demonstrate that the enrollee has performed an act or practice constituting fraud or made an intentional misrepresentation of material fact as prohibited by the terms of the contract. (b) If a plan intends to rescind a plan contract pursuant to subdivision (a), the plan shall send a notice to the enrollee or subscriber via regular certified mail at least 30 days prior to the effective date of the rescission explaining the reasons for the intended rescission and notifying the enrollee or subscriber of his or her right to appeal that decision to the director pursuant to subdivision (b) of Section 1365. (c) Notwithstanding subdivision (a), Section 1365 or any other provision of law, after 24 months following the issuance of a health care service plan contract, a plan shall not rescind the plan contract for any reason, and shall not cancel the plan contract, limit any of the provisions of the plan contract, or raise premiums on the plan contract due to any omissions, misrepresentations, or inaccuracies in the application form, whether willful or not. Nothing in this subdivision shall be construed to alter existing law that otherwise applies to a health care service plan within the first 24 months following the issuance of a health care service plan contract. (Amended by Stats. 2010, Ch. 658, Sec. 8. (AB 2470) Effective January 1, 2011.)
  178. 1389.25.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7.5. Underwriting Practices [1389.1 - 1389.8] ( Article 7.5 added by Stats. 1993, Ch. 1210, Sec. 3. )

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    Certain health care service plans must give advance written notice before premium or coverage changes take effect, and the notice must include specific pricing and benefit-change details.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7.5. Underwriting Practices [1389.1 - 1389.8] ( Article 7.5 added by Stats. 1993, Ch. 1210, Sec. 3. ) ## 1389.25. (a) (1) This section shall apply only to a full service health care service plan offering health coverage in the individual market in California and shall not apply to a specialized health care service plan, a health care service plan contract in the Medi-Cal program (Chapter 7 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code), a health care service plan conversion contract offered pursuant to Section 1373.6, a health care service plan contract in the Healthy Families Program (Part 6.2 (commencing with Section 12693) of Division 2 of the Insurance Code), or a health care service plan contract offered to a federally eligible defined individual under Article 4.6 (commencing with Section 1366.35). (2) A local initiative, as defined in subdivision (w) of Section 53810 of Title 22 of the California Code of Regulations, that is awarded a contract by the State Department of Health Care Services pursuant to subdivision (b) of Section 53800 of Title 22 of the California Code of Regulations, shall not be subject to this section unless the plan offers coverage in the individual market to persons not covered by Medi-Cal or the Healthy Families Program. (b) (1) No change in the premium rate or coverage for an individual plan contract shall become effective unless the plan has provided a written notice of the change at least 10 days prior to the start of the annual enrollment period applicable to the contract or 60 days prior to the effective date of the contract renewal, whichever occurs earlier in the calendar year. (2) The written notice required pursuant to paragraph (1) shall be provided to the individual contractholder at their last address known to the plan. The notice shall state in italics and in 12-point type the actual dollar amount of the premium rate increase and the specific percentage by which the current premium will be increased. The notice shall describe in plain, understandable English any changes in the plan design or any changes in benefits, including a reduction in benefits or changes to waivers, exclusions, or conditions, and highlight this information by printing it in italics. The notice shall specify in a minimum of 10-point bold typeface, the reason for a premium rate change or a change to the plan design or benefits. (c) (1) If the department determines that a rate is unreasonable or not justified consistent with Article 6.2 (commencing with Section 1385.01), the plan shall notify the contractholder of this determination. This notification may be included in the notice required in subdivision (b). The notification to the contractholder shall be developed by the department. The development of the notification required under this subdivision shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). (2) The notification to the contractholder shall include the following statements in 14-point type: (A) The Department of Managed Health Care has determined that the rate for this product is unreasonable or not justified after reviewing information submitted to it by the plan. (B) During the open enrollment period, the contractholder has the option to obtain other coverage from this plan or another plan, or to keep this coverage. (C) The contractholder may want to contact Covered California at www.coveredca.com for help in understanding available options. (D) Many Californians are eligible for financial assistance from Covered California to help pay for coverage. (3) The plan may include in the notification to the contractholder the internet website address at which the plan’s final justification for implementing an increase that has been determined to be unreasonable by the director may be found pursuant to Section 154.230 of Title 45 of the Code of Federal Regulations. (4) The notice shall also be provided to the solicitor for the contractholder, if any, so that the solicitor may assist the purchaser in finding other coverage. (5) In developing the notification, the department shall take into consideration that this notice is required to be provided to an individual applicant pursuant to subdivision (g) of Section 1385.03. (d) (1) Before July 1, 2024, if a plan rejects a dependent of a subscriber applying to be added to the subscriber’s individual grandfathered health plan, rejects an applicant for a Medicare supplement plan contract due to the applicant having end-stage renal disease, or offers an individual grandfathered health plan to an applicant at a rate that is higher than the standard rate, the plan shall inform the applicant about the California Major Risk Medical Insurance Program (MRMIP) (Chapter 4 (commencing with Section 15870) of Part 3.3 of Division 9 of the Welfare and Institutions Code) and about new coverage options and the potential for subsidized coverage through Covered California. The plan shall direct persons seeking more information to MRMIP, Covered California, plan or policy representatives, insurance agents, or an entity paid by Covered California to assist with health coverage enrollment, such as a navigator or an assister. (2) On or after July 1, 2024, if a plan rejects a dependent of a subscriber applying to be added to the subscriber’s individual grandfathered health plan, rejects an applicant for a Medicare supplement plan contract due to the applicant having end-stage renal disease, or offers an individual grandfathered health plan to an applicant at a rate that is higher than the standard rate, the plan shall inform the applicant about new coverage options and the potential for subsidized coverage through Covered California. The plan shall direct persons seeking more information to Covered California, plan or policy representatives, insurance agents, or an entity paid by Covered California to assist with health coverage enrollment, such as a navigator or an assister. (e) A notice provided pursuant to this section is a private and confidential communication and, at the time of application, the plan shall give the individual applicant the opportunity to designate the address for receipt of the written notice in order to protect the confidentiality of any personal or privileged information. (f) For purposes of this section, the following definitions shall apply: (1) “Covered California” means the California Health Benefit Exchange established pursuant to Section 100500 of the Government Code. (2) “Grandfathered health plan” has the same meaning as that term is defined in Section 1251 of PPACA. (3) “PPACA” means the federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), and any rules, regulations, or guidance issued pursuant to that law. (Amended by Stats. 2024, Ch. 40, Sec. 12. (SB 159) Effective June 29, 2024.)
  179. 1389.3.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7.5. Underwriting Practices [1389.1 - 1389.8] ( Article 7.5 added by Stats. 1993, Ch. 1210, Sec. 3. )

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    A health care service plan must not engage in postclaims underwriting.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7.5. Underwriting Practices [1389.1 - 1389.8] ( Article 7.5 added by Stats. 1993, Ch. 1210, Sec. 3. ) ## 1389.3. No health care service plan shall engage in the practice of postclaims underwriting. For purposes of this section, “postclaims underwriting” means the rescinding, canceling, or limiting of a plan contract due to the plan’s failure to complete medical underwriting and resolve all reasonable questions arising from written information submitted on or with an application before issuing the plan contract. This section shall not limit a plan’s remedies described in subdivision (a) of Section 1389.21. (Amended by Stats. 2010, Ch. 658, Sec. 9. (AB 2470) Effective January 1, 2011.)
  180. 1389.5.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7.5. Underwriting Practices [1389.1 - 1389.8] ( Article 7.5 added by Stats. 1993, Ch. 1210, Sec. 3. )

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    A health care service plan must let certain long-term individual enrollees transfer once a year to another plan contract without medical underwriting, and must give ranking and written notice requirements.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7.5. Underwriting Practices [1389.1 - 1389.8] ( Article 7.5 added by Stats. 1993, Ch. 1210, Sec. 3. ) ## 1389.5. (a) This section applies to a health care service plan that provides coverage under an individual plan contract that is issued, amended, delivered, or renewed on or after January 1, 2007. (b) At least once each year, the health care service plan shall permit an individual who has been covered for at least 18 months under an individual plan contract to transfer, without medical underwriting, to any other individual plan contract offered by that same health care service plan that provides equal or lesser benefits, as determined by the plan. “Without medical underwriting” means that the health care service plan shall not decline to offer coverage to, or deny enrollment of, the individual or impose any preexisting condition exclusion on the individual who transfers to another individual plan contract pursuant to this section. (c) The plan shall establish, for the purposes of subdivision (b), a ranking of the individual plan contracts it offers to individual purchasers and post the ranking on its Internet Web site or make the ranking available upon request. The plan shall update the ranking whenever a new benefit design for individual purchasers is approved. (d) The plan shall notify in writing all enrollees of the right to transfer to another individual plan contract pursuant to this section, at a minimum, when the plan changes the enrollee’s premium rate. Posting this information on the plan’s Internet Web site shall not constitute notice for purposes of this subdivision. The notice shall adequately inform enrollees of the transfer rights provided under this section, including information on the process to obtain details about the individual plan contracts available to that enrollee and advising that the enrollee may be unable to return to his or her current individual plan contract if the enrollee transfers to another individual plan contract. (e) The requirements of this section do not apply to the following: (1) A federally eligible defined individual, as defined in subdivision (c) of Section 1399.801, who is enrolled in an individual health benefit plan contract offered pursuant to Section 1366.35. (2) An individual offered conversion coverage pursuant to Section 1373.6. (3) Individual coverage under a specialized health care service plan contract. (4) An individual enrolled in the Medi-Cal program pursuant to Chapter 7 (commencing with Section 14000) of Division 9 of Part 3 of the Welfare and Institutions Code. (5) An individual enrolled in the Access for Infants and Mothers Program pursuant to Part 6.3 (commencing with Section 12695) of Division 2 of the Insurance Code. (6) An individual enrolled in the Healthy Families Program pursuant to Part 6.2 (commencing with Section 12693) of Division 2 of the Insurance Code. (f) It is the intent of the Legislature that individuals shall have more choice in their health coverage when health care service plans guarantee the right of an individual to transfer to another product based on the plan’s own ranking system. The Legislature does not intend for the department to review or verify the plan’s ranking for actuarial or other purposes. (g) (1) This section shall become inoperative January 1, 2014, or the 91st calendar day following the adjournment of the 2013–14 First Extraordinary Session, whichever date is later. (2) If Section 5000A of the Internal Revenue Code, as added by Section 1501 of PPACA, is repealed or amended to no longer apply to the individual market, as defined in Section 2791 of the federal Public Health Service Act (42 U.S.C. Sec. 300gg-91), this section shall become operative 12 months after the date of that repeal or amendment. (Amended by Stats. 2015, Ch. 303, Sec. 263. (AB 731) Effective January 1, 2016. Inoperative, by its own provisions, on January 1, 2014, subject to condition for resuming operation.)
  181. 1389.6.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7.5. Underwriting Practices [1389.1 - 1389.8] ( Article 7.5 added by Stats. 1993, Ch. 1210, Sec. 3. )

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    A health care service plan may not tie compensation or performance goals to rescissions, cancellations, limitations, or the related cost savings.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7.5. Underwriting Practices [1389.1 - 1389.8] ( Article 7.5 added by Stats. 1993, Ch. 1210, Sec. 3. ) ## 1389.6. Compensation of a person or entity employed by, or contracted with, a health care service plan shall not be based on, or related in any way to, the number of contracts that the person or entity has caused or recommended to be rescinded, canceled, or limited, or the resulting cost savings to the health plan. A health care service plan shall not set performance goals or quotas, or provide compensation to any person or entity employed by, or contracted with, the health care service plan, based on the number of persons whose coverage is rescinded or any financial savings to the health care service plan associated with rescission of coverage. (Added by Stats. 2008, Ch. 188, Sec. 1. Effective January 1, 2009.)
  182. 1389.8.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7.5. Underwriting Practices [1389.1 - 1389.8] ( Article 7.5 added by Stats. 1993, Ch. 1210, Sec. 3. )

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    People who help applicants submit health plan applications must help answer health questions accurately, attest that the application is complete and accurate, and explain the risk of inaccurate information. False material statements in those attestations can trigger a civil penalty of up to $20,000.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 7.5. Underwriting Practices [1389.1 - 1389.8] ( Article 7.5 added by Stats. 1993, Ch. 1210, Sec. 3. ) ## 1389.8. (a) Notwithstanding any other provision of law, an agent, broker, solicitor, solicitor firm, or representative who assists an applicant in submitting an application to a health care service plan has the duty to assist the applicant in providing answers to health questions accurately and completely. (b) An agent, broker, solicitor, solicitor firm, or representative who assists an applicant in submitting an application to a health care service plan shall attest on the written application to both of the following: (1) That to the best of their knowledge, the information on the application is complete and accurate. (2) That they explained to the applicant, in easy-to-understand language, the risk to the applicant of providing inaccurate information and that the applicant understood the explanation. (c) If, in an attestation required by subdivision (b), a declarant willfully states as true any material fact the declarant knows to be false, that person shall, in addition to any applicable penalties or remedies available under current law, be subject to a civil penalty of up to twenty thousand dollars ($20,000). Any public prosecutor may bring a civil action to impose that civil penalty. These penalties shall be paid to the Managed Care Fund. (d) A health care service plan application shall include a statement advising declarants of the civil penalty authorized under this section. (e) Commencing January 1, 2028, and every five years thereafter, the penalty amount specified in this section shall be adjusted based on the average rate of change in premium rates for the individual and small group markets, and weighted by enrollment, since the previous adjustment. (Amended by Stats. 2022, Ch. 985, Sec. 6. (SB 858) Effective January 1, 2023.)
  183. 13890.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    Each district board must adopt a preliminary budget by June 30 each year.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13890. On or before June 30 of each year, a district board shall adopt a preliminary budget which shall conform to the accounting and budgeting procedures for special districts contained in Subchapter 3 (commencing with Section 1031.1) of, and Article 1 (commencing with Section 1121) of Subchapter 4 of, Chapter 2 of Division 2 of Title 2 of the California Code of Regulations. (Amended by Stats. 1999, Ch. 550, Sec. 27. Effective September 28, 1999. Operative January 1, 2000, by Sec. 33 of Ch. 550.)
  184. 13891.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    Amounts in a preliminary budget are treated as appropriated after July 1 each year until the district board adopts the final budget, except for fixed-asset obligations and new permanent employee positions.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13891. On or after July 1 of each year, the amounts set forth in the preliminary budget, except obligations for fixed assets and new permanent employee positions, are deemed appropriated until the district board adopts the final budget. If the district board has not adopted a preliminary budget, the amounts deemed appropriated shall be based on the budget of the preceding year, excluding fixed assets and new permanent employee positions. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  185. 13892.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    If the district board finds next year’s revenue will be too low for needed fire-protection spending, the preliminary budget must propose ways to raise more revenue or cut services.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13892. If the district board determines that the amount of revenue for the coming fiscal year will be inadequate to meet the amount of expenditures needed to protect life and property, the preliminary budget shall propose methods of raising adequate revenues or reducing services. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  186. 13893.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    A district board must give annual public notice of its preliminary and final budget meeting details by June 30, and publish it in a newspaper or, if none is published in the district, post it in three public places.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13893. (a) On or before June 30 of each year, a district board shall publish a notice stating all of the following: (1) That it has adopted a preliminary budget which is available for inspection at a time and place within the district specified in the notice. (2) The date, time, and place when the board will meet to adopt the final budget and that any person may appear and be heard regarding any item in the budget or regarding the addition of other items. (b) The notice shall be published pursuant to Section 6061 of the Government Code in at least one newspaper of general circulation in the district. The first publication shall be at least two weeks before the date of the meeting. If there is no newspaper published in the district, the notice shall be posted in three public places in the district at least two weeks before the date of the meeting. (Amended by Stats. 1993, Ch. 1195, Sec. 21. Effective January 1, 1994.)
  187. 13894.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    Any person may speak at the specified meeting about budget items or adding new items, and the preliminary budget hearing may be continued.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13894. At the time and place specified for the meeting, any person may appear and be heard regarding any item in the budget or regarding the addition of other items. The hearing on the preliminary budget may be continued from time to time. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  188. 13895.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    The board must adopt a final budget by October 1 each year, after making any changes to the preliminary budget.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13895. On or before October 1 of each year, after making any changes in the preliminary budget, the board shall adopt a final budget. The final budget shall establish its appropriation limit pursuant to Division 9 (commencing with Section 7900) of Title 1 of the Government Code. A copy of the final budget shall be forwarded to the auditor of each county in which the district is located. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  189. 13896.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. )

    Verify source ↗

    County auditors must allocate each district’s share of property tax revenue as required by the cited Revenue and Taxation Code chapter.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13896. The auditor of each county in which a district is located shall allocate to the district its share of property tax revenue pursuant to Chapter 6 (commencing with Section 95) of Part 0.5 of Division 1 of the Revenue and Taxation Code. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  190. 13897.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    A district may borrow money and incur debt under the authority of specified Government Code articles.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13897. A district may borrow money and incur indebtedness pursuant to the authority contained in Article 7 (commencing with Section 53820), Article 7.4 (commencing with Section 53835), Article 7.5 (commencing with Section 53840), Article 7.6 (commencing with Section 53850), and Article 7.7 (commencing with Section 53859), of Chapter 4 of Part 1 of Division 2 of Title 5 of the Government Code. (Amended by Stats. 2010, Ch. 699, Sec. 25.3. (SB 894) Effective January 1, 2011.)
  191. 13898.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    A district may accept revenue, money, grants, goods, or services from government agencies or any person for any lawful district purpose.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13898. A district may accept any revenue, money, grants, goods, or services from any federal, state, regional, or local agency or from any person for any lawful purpose of the district. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  192. 13899.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    Taxes and assessments under this chapter must be handled on the county assessment roll, collected like other county taxes, and paid into the county treasury for district use.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13899. All taxes and assessments levied under this chapter shall be computed and entered on the county assessment roll and collected at the same time and in the same manner as other county taxes. When collected, the taxes and assessments shall be paid into the county treasury for the use of the district. Except as provided in Section 13854, the county may deduct its costs for this service pursuant to Section 29142 of the Government Code. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  193. 1390.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 8. Other Enforcement Procedures [1390 - 1394.3] ( Article 8 added by Stats. 1975, Ch. 941. )

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    A person who willfully violates this chapter or related rules/orders can be fined or imprisoned; a person cannot be imprisoned for violating a rule or order if they had no knowledge of it.

    ## Health and Safety Code - HSC ## DIVISION 2. LICENSING PROVISIONS [1200 - 1796.88] ( Division 2 enacted by Stats. 1939, Ch. 60. ) ## CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874] ( Chapter 2.2 added by Stats. 1975, Ch. 941. ) ## ARTICLE 8. Other Enforcement Procedures [1390 - 1394.3] ( Article 8 added by Stats. 1975, Ch. 941. ) ## 1390. (a) Any person who willfully violates any provision of this chapter or of any rule or order thereunder shall upon conviction be fined not more than twenty thousand dollars ($20,000) or imprisoned pursuant to subdivision (h) of Section 1170 of the Penal Code, or in a county jail for not more than one year, or be punished by both that fine and imprisonment, but no person may be imprisoned for the violation of any rule or order if it is proven that the person had no knowledge of the rule or order. (b) Commencing January 1, 2028, and every five years thereafter, the fine amount specified in this section shall be adjusted based on the average rate of change in premium rates for the individual and small group markets, and weighted by enrollment, since the previous adjustment. (Amended by Stats. 2022, Ch. 985, Sec. 7. (SB 858) Effective January 1, 2023.)
  194. 13900.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    A district board may, by a two-thirds vote at a regular or properly noticed special meeting, make certain funds available for appropriation.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13900. At any regular meeting or properly noticed special meeting, a district board by two-thirds majority vote of the total membership of the district board may make available for appropriation any of the following: (a) Balances in appropriations for contingencies, including accretions from cancellations of appropriations. (b) Designations and reserves no longer required for the purpose for which intended, excluding the general reserve, balance sheet reserves, and reserve for encumbrances. (c) Amounts which are either in excess of anticipated amounts or not specifically set forth in the budget derived from any or anticipated increases in available financing. (Added by Stats. 1987, Ch. 1013, Sec. 11.)
  195. 13901.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    If a district faces an emergency that affects its ability to provide fire protection or related services, the district board may, by two-thirds vote, make certain received moneys available for appropriation and expenditure during the current fiscal year.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13901. If it finds that an emergency affects the ability of a district to furnish adequate fire protection services, rescue services, emergency medical services, hazardous material emergency response services, ambulance services, or other services relating to the protection of lives and property, a district board, by resolution adopted by a two-thirds vote of the total membership of the district board, may provide the moneys which have been received but not specifically set forth as revenue in the adopted final budget be made available for appropriation and expenditure during the current fiscal year. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  196. 13902.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    A district board may create a reserve for capital outlays, must state what it will be used for, and may later move certain surplus reserve money into it or discontinue it under stated conditions.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13902. (a) A district board may establish a reserve for capital outlays and shall declare the purposes for which the reserve is to be used. (b) At any time, the district board may transfer to its reserve for capital outlays any unencumbered surplus reserve remaining at the end of a fiscal year. (c) A capital outlay reserve shall be used only for the purposes specified by the district board. However, if a district board finds at the time it adopts its final budget that the reserve is no longer required, it may, by unanimous vote, discontinue the reserve or transfer any balance to the district’s general fund. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  197. 13903.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    Claims against a district must be audited, allowed, and paid by order of the district board. The board may instead direct the county auditor to handle the audit, allowance, and warrant process for legal claims. Warrants must be paid in presentation order.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13903. (a) All claims for money or damages against a district are governed by Part 3 (commencing with Section 900) and Part 4 (commencing with Section 940) of Division 3.6 of Title 1 of the Government Code. (b) Claims against a district shall be audited, allowed, and paid by order of the district board. (c) As an alternative to subdivision (b), a district board may instruct the county auditor to audit, allow, and draw his or her warrant on the county treasurer for all legal claims presented to him or her and authorized by the district board. (d) The warrants shall be paid in the order in which they are presented. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  198. 13904.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    If the district treasurer cannot pay a presented warrant because the account has insufficient funds, the treasurer must mark it “NOT PAID BECAUSE OF INSUFFICIENT FUNDS,” sign it, and record the presentation date and time.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13904. If a warrant is presented to the district treasurer for payment and the treasurer cannot pay it for want of funds in the account on which it is drawn, the treasurer shall endorse the warrant “NOT PAID BECAUSE OF INSUFFICIENT FUNDS” and sign his or her name and indicate the date and time the warrant was presented. From that time until it is paid, the warrant bears interest at the maximum rate permitted pursuant to Article 7 (commencing with Section 53530) of Chapter 3 of Part 1 of Division 2 of Title 5 of the Government Code. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  199. 13905.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    A district board may create a petty cash fund by resolution, but the resolution must specify the fund’s maximum amount, purposes, and who may spend, account for, and draw warrants for it.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13905. Notwithstanding Section 13903, a district board may adopt a resolution ordering the establishment of a petty cash fund to pay small bills directly. The resolution shall designate all of the following: (a) The maximum amount of the fund, not to exceed five hundred dollars ($500). (b) The purposes for which the fund may be spent. (c) The officer or employee who is authorized to spend the fund and who will account for it. (d) The officer or employee who is authorized to draw a warrant on the district treasury to establish the fund and who is authorized to draw additional warrants to reimburse the fund. Each warrant drawn to reimburse the fund shall contain an itemized account of expenditures. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)
  200. 13906.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. )

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    A district may buy needed property with borrowed money, but the borrowing is capped, must be repaid within 10 years, and must be approved by a two-thirds board vote.

    ## Health and Safety Code - HSC ## DIVISION 12. FIRES AND FIRE PROTECTION [13000 - 14959] ( Division 12 enacted by Stats. 1939, Ch. 60. ) ## PART 2.7. FIRE PROTECTION DISTRICT LAW OF 1987 [13800 - 13970] ( Heading of Part 2.7 renumbered from Part 3 (as added by Stats. 1987, Ch. 1013) by Stats. 1989, Ch. 1360, Sec. 91. ) ## CHAPTER 7. Finance [13890 - 13906] ( Chapter 7 added by Stats. 1987, Ch. 1013, Sec. 11. ) ## 13906. (a) A district may acquire any necessary property by purchase or purchase on contract with money borrowed pursuant to this section. (b) The amount of indebtedness to be incurred shall not exceed an amount equal to three times the actual income from property taxes received pursuant to Section 13896 for the fiscal year preceding the year in which the indebtedness is incurred. Any indebtedness shall be repaid within 10 years from the date on which it is incurred. An indebtedness shall bear interest at a rate which shall not exceed the rate permitted under Article 7 (commencing with Section 53530) of Chapter 3 of Part 1 of Division 2 of Title 5 of the Government Code. (c) An indebtedness shall be authorized by resolution adopted by a two-thirds majority vote of the total membership of the district board. (Repealed and added by Stats. 1987, Ch. 1013, Sec. 11.)

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