Health Care Insurance

Cal. WIC § 10020

California Statutes

(

a) No person having private health care coverage shall be entitled to receive the same health care items or services furnished or paid for by a publicly funded health care program. (

b) As used in this chapter: (1) “Publicly funded health care program” shall mean care or services rendered by a local government or any facility thereof, or health care services for which payment is made under the California Medical Assistance Program established by

Chapter 7 (commencing with

Section 14000) of Part of this division by the State Department of Health Services or by its fiscal intermediary, or by a carrier or other organization with which the State Department of Health Services has contracted to furnish those services or to pay providers who furnish those services.

(2) As used in this chapter, “private health care coverage” means any health insurer, self-insured plan, group health plan, as defined in

Section 607(1) of the Employee Retirement Income Security Act of 1974, service benefit plan, managed care organization, including health care service plans as defined in subdivision (

f) of

Section of the Health and Safety Code, licensed pursuant to the Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2 (commencing with

Section 1340) of Division of the Health and Safety Code, pharmacy benefit manager, or other party that is, by statute, contract, or agreement, legally responsible for payment of a claim for a health care item or service. (

c) If a person receives health care furnished or paid for by a publicly funded health care program, the carrier of the person’s private health care coverage shall reimburse the publicly funded health care program the cost incurred in rendering that care to the extent of the benefits provided under the terms of the policy for the items provided or the services rendered.

Document details

CollectionCalifornia Statutes
CitationCal. WIC § 10020
Date2007-08-24
Typestatute
Languageen
SourceCA_STAT
IdentifierWIC10020.200718832

Health Care Insurance

Cal. WIC § 10020

California Statutes

Health Care Insurance

Cal. WIC § 10020

California Statutes

(

a) No person having private health care coverage shall be entitled to receive the same health care items or services furnished or paid for by a publicly funded health care program. (

b) As used in this chapter: (1) “Publicly funded health care program” shall mean care or services rendered by a local government or any facility thereof, or health care services for which payment is made under the California Medical Assistance Program established by

Chapter 7 (commencing with

Section 14000) of Part of this division by the State Department of Health Services or by its fiscal intermediary, or by a carrier or other organization with which the State Department of Health Services has contracted to furnish those services or to pay providers who furnish those services.

(2) As used in this chapter, “private health care coverage” means any health insurer, self-insured plan, group health plan, as defined in

Section 607(1) of the Employee Retirement Income Security Act of 1974, service benefit plan, managed care organization, including health care service plans as defined in subdivision (

f) of

Section of the Health and Safety Code, licensed pursuant to the Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2 (commencing with

Section 1340) of Division of the Health and Safety Code, pharmacy benefit manager, or other party that is, by statute, contract, or agreement, legally responsible for payment of a claim for a health care item or service. (

c) If a person receives health care furnished or paid for by a publicly funded health care program, the carrier of the person’s private health care coverage shall reimburse the publicly funded health care program the cost incurred in rendering that care to the extent of the benefits provided under the terms of the policy for the items provided or the services rendered.

Document details

CollectionCalifornia Statutes
CitationCal. WIC § 10020
Date2007-08-24
Typestatute
Languageen
SourceCA_STAT
IdentifierWIC10020.200718832