Section 2699.6405 - HearingsWhen an appeal which requests an administrative hearing is received, the appeal shall be set for hearing as follows:
(a) Administrative hearings of appeals will be conducted according to the appeal procedures, including pre- and post-hearing procedures, set forth in Chapter 2.5 (commencing with section 251) of Division 2 of Title 1 of the California Code of Regulations. Chapter 2.5 is hereby incorporated by reference, subject to the following modifications: (1) Reference to the Health and Welfare Agency or the component department shall be deemed reference to the Managed Risk Medical Insurance Board.(2) Reference to the private non-profit human service organization shall be deemed reference to the petitioner.(3) Reference to the grievance procedure established in accordance with Health and Safety Code section 38036 shall be deemed reference to the administrative review process set forth in section 2699.6403.(4) Reference to Health and Safety Code sections providing the bases, grounds, authorization or procedures for appeals shall be deemed reference to the bases and authorization for appeal found in section 2699.6400, and the appeal procedures found in this section.(5) The 30-day time period specified in section 251(b) shall be extended to 60 days, and the 10-day time period in section 252(a) shall be extended to 30 days.(6) If the proposed decision submitted to the Board is not adopted as the decision, the Board may itself decide the case on the record, or may refer the case to the same hearing officer to take additional evidence. If the case is referred back to the hearing officer, the hearing officer shall prepare a new proposed decision based on the additional evidence and the record of the prior hearing.(7) The decision of the Board shall be issued within 90 days following the initial hearing or, if the case is referred back to the hearing officer, within 90 days of the second hearing.(b) The Board may elect to have a hearing conducted by an Administrative Law Judge employed by the Office of Administrative Hearings pursuant to the provisions of Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code.Cal. Code Regs. Tit. 10, § 2699.6405
1. Renumbering of former section 2699.653 to section 2699.6405 filed 5-27-94; operative 5-27-94 (Register 94, No. 21).
2. Amendment of subsection (a) and new subsections (a)(1)-(a)(7) filed 1-10-95 as an emergency; operative 1-10-95 (Register 95, No. 2). A Certificate of Compliance must be transmitted to OAL 5-10-95 or emergency language will be repealed by operation of law on the following day.
3. Certificate of Compliance as to 1-10-95 order including amendment of subsection (a) transmitted to OAL 4-25-95 and filed 6-7-95 (Register 95, No. 23). Note: Authority cited: Section 10731, Insurance Code. Reference: Sections 10731 and 10748, Insurance Code.
1. Renumbering of former section 2699.653 to section 2699.6405 filed 5-27-94; operative 5-27-94 (Register 94, No. 21).
2. Amendment of subsection (a) and new subsections (a)(1)-(a)(7) filed 1-10-95 as an emergency; operative 1-10-95 (Register 95, No. 2). A Certificate of Compliance must be transmitted to OAL 5-10-95 or emergency language will be repealed by operation of law on the following day.
3. Certificate of Compliance as to 1-10-95 order including amendment of subsection (a) transmitted to OAL 4-25-95 and filed 6-7-95 (Register 95, No. 23).