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Chapter 4.5. Division of Workers' Compensation
Subchapter 1. Administrative Director--Administrative Rules
Article 4. Certification Standards for Health Care Organizations

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§9779.1. On-Site Surveys.

(a) The HCO must ensure that it will be available for and cooperate with on-site surveys as the administrative director deems necessary to insure compliance with this article, including during the initial certification process. The administrative director will coordinate on-site surveys with the Department of Managed Health Care to the extent feasible.

(b) The administrative director will notify the HCO of deficiencies found by the survey team. The administrative director will provide the HCO a reasonable time to correct the deficiencies. Failure on the part of the HCO to timely correct noted deficiencies may result in suspension or revocation of an HCO's certification in accordance with Section 9779.2.

(c) Reports of all surveys shall be open to public inspection, except that no survey shall be made public unless the HCO has had an opportunity to review the survey and file a statement in response within 30 days, to be attached to the report. Deficiencies shall not be made public if they are corrected within 30 days of the date that the HCO was notified.

(d) Non-routine audits will be charged based on the actual cost for performing the audit. The amount shall include the actual salaries or compensation paid to the persons making the audit, the expenses incurred in the course thereof, and overhead costs in connection therewith as fixed by the Administrative Director. Overhead costs shall be based on the total expenditure for operating expenses and equipment, except travel, of the managed care unit of the Division of Workers' Compensation for the previous fiscal year. The invoice will be sent upon the completion of the audit and shall be paid within 30 calendar days.

NOTE

Authority cited: Sections 133, 4600.5, 4600.7, 4603.5 and 5307.3, Labor Code. Reference: Sections 4600, 4600.5 and 4600.7, Labor Code.

HISTORY

1. New section filed 12-31-93; operative 1-1-94. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 93, No. 53).

2. Editorial correction of section heading (Register 96, No. 7).

3. New subsection (d) and amendment of Note filed 2-14-96; operative 2-14-96. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 96, No. 7).

4. Amendment of subsection (a) filed 1-9-2003; operative 1-9-2003 pursuant to Government Code section 11343.4 (Register 2003, No. 2).

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