Cal. Code Regs. tit. 22 § 51211.5

Current through Register 2024 Notice Reg. No. 49, December 6, 2024

Section 51211.5 - Rural Health Clinic Standards for Participation

(a) Each rural health clinic shall:

(1) Be licensed or exempt from licensure under Chapter 1, Division 2, California Health and Safety Code.

(2) Be located in a rural shortage area at the time of initial certification or be a private, nonprofit facility that meets all other conditions except for location in a shortage area and was operating in a rural area on July 1, 1977 that was subsequently determined by the Secretary, Department of Health and Human Services, to have an insufficient supply of physicians to meet the needs of the area served.

(3) Be certified and continue to meet the standards for certification as a rural health clinic established by the Secretary, Department of Health and Human Services.

(4) Provide that a physician or nonphysician medical practitioner be available to furnish patient care services at all hours of clinic operation. A nonphysician medical practitioner shall be available to furnish patient care services at least 60 percent of the hours of clinic operation.

(5) Execute a provider participation agreement with the Director containing, but not limited to, the following provisions:

(A) The participation agreement shall be subject to the same terms and conditions, and be coterminous with the period of eligibility, specified by the Secretary, Department of Health and Human Services.

(B) The participation agreement, including that of a provider who voluntarily withdraws from participation in Medicare, shall continue to be valid only if the provider continues to be certified as meeting the standards as a rural health clinic established by the Secretary, Department of Health and Human Services.

(C) The provider may terminate the participation agreement by filing a written notice with the Director stating the effective date of termination. The Director may approve:

1. The date selected by the clinic.

2. A date that is six months after the date on which the clinic filed notice.

3. A date that is less than six months after the date on which the clinic filed notice if the Director determines that termination on that date would not unduly disrupt service to the community served or interfere with the administration of the Medi-Cal program.

(D) A clinic that ceases to furnish services to the community shall be deemed to have voluntarily terminated the participation agreement, effective on the last day of service.

(6) Maintain any records and accounts required by the Director in accordance with State and Federal law.

(b) The Department shall take appropriate action to deny or terminate the rural health clinic's participation under Medi-Cal upon notification that a provider participation agreement with a facility under Title XVIII of the Act has been terminated.

(c) A clinic whose agreement has been cancelled or otherwise terminated by the Department shall not be issued another provider participation agreement until the reasons which caused the cancellation or termination have been removed and a reasonable assurance provided the survey agency that they will not recur.

Cal. Code Regs. Tit. 22, § 51211.5

1. New section filed 8-1-78 as an emergency; effective upon filing (Register 78, No. 31).
2. Certificate of Compliance transmitted to OAH 11-28-78 and filed 11-29-78 (Register 78, No. 48).
3. Amendment of subsections (a)(5) and (6) and new subsections (b) and (c) filed 2-5-79; effective thirtieth day thereafter (Register 79, No. 6).
4. Amendment of subsection (a) filed 6-22-87; operative 7-22-87 (Register 87, No. 27).

Note: Authority cited: Sections 14100.1, 14105 and 14124.5, Welfare and Institutions Code. Reference: Sections 14100.1, 14105 and 14124.5, Welfare and Institutions Code.