Section 1850.212 - Contents of a Notice of Action(a) The Notice of Action, issued pursuant to Section 1850.210(a)-(e) shall contain the following information:(1) The action taken by the MHP.(2) The reason for the action taken.(3) A citation of the specific regulations or MHP payment authorization procedures supporting the action.(4) The beneficiary's right to file an appeal or expedited appeal with the MHP.(5) The beneficiary's right to a fair hearing or to request an expedited fair hearing, including: (A) The method by which a hearing may be obtained.(B) That the beneficiary may be either:2. Represented by an authorized third party such as legal counsel, relative, friend or any other person.(C) An explanation of the circumstances under which a specialty mental health service will be continued if a fair hearing is requested.(D) The time limits for requesting a fair hearing or an expedited fair hearing.(b) A Notice of Action, issued pursuant to Section 1850.210(g), shall specify the following:(1) The reason that the medical necessity criteria were not met, including a citation of the applicable regulation.(2) The beneficiary's options for obtaining care outside the MHP, if applicable.(3) The beneficiary's right to request a second opinion on the determination.(4) The beneficiary's right to file an appeal or expedited appeal with the MHP.(5) The beneficiary's right to a fair hearing or to request an expedited fair hearing, including: (A) The method by which a hearing may be obtained.(B) That the beneficiary may be either:2. Represented by an authorized third party such as legal counsel, relative, friend or any other person.(C) The time limits for requesting a fair hearing or an expedited fair hearing.Cal. Code Regs. Tit. 9, § 1850.212
1. New section filed 5-19-2006; operative 6-18-2006 (Register 2006, No. 20). Note: Authority cited: Section 14680, Welfare and Institutions Code. Reference: Section 14684, Welfare and Institutions Code; and Title 42, Code of Federal Regulations, Section 431.244 and Part 438, Subpart F.
1. New section filed 5-19-2006; operative 6-18-2006 (Register 2006, No. 20).