Audit, Appeal, and Recovery of Overpayments

Cal. WIC § 14170.11

California Statutes

(

a) No person or entity shall submit a claim to the department or its fiscal intermediaries for reimbursement under the Medi-Cal program for a nerve conduction test or for electromyography unless the person or entity’s records contains a copy, for each person performing each test or electromyography, for which a claim is submitted, a certificate or diploma of satisfactory completion of a neurology or physical medicine and rehabilitation residency program accredited by the Accreditation Council of Graduate Medical Education (ACGME). (

b) The department may identify by publication, in provider bulletins or similar instructions, requirements that reimbursement from the Medi-Cal program shall only be made for the provision of certain procedures, tests, examinations, or other medical services provided by persons who possess a particular level of education, experience, and training as evidenced by satisfactory completion of medical residency programs or board certification in a particular field and that those submitting claims shall maintain a copy of this certificate or diploma. (

c) Notwithstanding

Chapter 3.5 (commencing with

Section 11340) of Part of Division of Title of the Government Code, the department may implement, interpret, or make specific, this

section by means of all county letters, provider bulletins, or similar instructions. Thereafter, the department may adopt regulations in accordance with the requirements of

Chapter 3.5 (commencing with

Section 11340) of Part of Division of Title of the Government Code.

Document details

CollectionCalifornia Statutes
CitationCal. WIC § 14170.11
Date2004-08-16
Typestatute
Languageen
SourceCA_STAT
IdentifierWIC14170.11.200422825

Audit, Appeal, and Recovery of Overpayments

Cal. WIC § 14170.11

California Statutes

Audit, Appeal, and Recovery of Overpayments

Cal. WIC § 14170.11

California Statutes

(

a) No person or entity shall submit a claim to the department or its fiscal intermediaries for reimbursement under the Medi-Cal program for a nerve conduction test or for electromyography unless the person or entity’s records contains a copy, for each person performing each test or electromyography, for which a claim is submitted, a certificate or diploma of satisfactory completion of a neurology or physical medicine and rehabilitation residency program accredited by the Accreditation Council of Graduate Medical Education (ACGME). (

b) The department may identify by publication, in provider bulletins or similar instructions, requirements that reimbursement from the Medi-Cal program shall only be made for the provision of certain procedures, tests, examinations, or other medical services provided by persons who possess a particular level of education, experience, and training as evidenced by satisfactory completion of medical residency programs or board certification in a particular field and that those submitting claims shall maintain a copy of this certificate or diploma. (

c) Notwithstanding

Chapter 3.5 (commencing with

Section 11340) of Part of Division of Title of the Government Code, the department may implement, interpret, or make specific, this

section by means of all county letters, provider bulletins, or similar instructions. Thereafter, the department may adopt regulations in accordance with the requirements of

Chapter 3.5 (commencing with

Section 11340) of Part of Division of Title of the Government Code.

Document details

CollectionCalifornia Statutes
CitationCal. WIC § 14170.11
Date2004-08-16
Typestatute
Languageen
SourceCA_STAT
IdentifierWIC14170.11.200422825
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