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

§9771.60 Further Definitions.

The following definitions apply to the interpretation of these rules and the Act:

(a) “Act” means Sections 4600.3, 4600.5 and 4600.6 of the Code

(b) “Advertisement” includes the disclosure form required pursuant to Section 4600.6(e) of the Code.

(c)(1) An “affiliate” of a person is a person controlled by, under common control with, or controlling such person.

(2) A person's relationship with another person is that of an “affiliated person” if such person is, as to such other person, a director, trustee or a member of its executive committee or other governing board or committee, or that of an officer or general partner, or holds any other position involving responsibility and authority similar to that of a principal officer or general partner; or who is the holder of 5 percent or more of its outstanding equity securities; or who has any such relationship with an affiliate of such person. An affiliate is also an affiliated person.

(d) The term “control” (including the terms “controlling,” “controlled by” and “under common control with”) means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting shares, debt, by contract, or otherwise.

(e) The term “certified” or “audited,” when used in regard to financial statements, means examined and reported upon with an opinion expressed by an independent public or certified public accountant.

(f) “Code” means the California Labor Code.

(g) “Administrative Director” means the Administrative Director of the Division of Workers' Compensation.

(h) “Facility” means

(1) any premises owned, leased, used or operated directly or indirectly by or for the benefit of an organization or any affiliate thereof, and

(2) any premises maintained by a provider to provide services on behalf of an organization.

(i) “Material”: A factor is “material” with respect to a matter if it is one to which a reasonable person would attach importance in determining the action to be taken upon the matter.

(j) “Principal creditor” means

(1) a person who has loaned funds to another for the operation of such other person's business, and

(2) a person who has, directly or indirectly, 20 percent or more of the outstanding debts of a person.

(k) “Principal officer” means a president, vice-president, secretary, treasurer or chairman of the board of a corporation, a sole proprietor, the managing general partner of a partnership, or a person having similar responsibilities or functions.

(l) The term “generally accepted accounting principles,” when used in regard to financial statements, assets, liabilities and other accounting items, means generally accepted accounting principles as used by business enterprises organized for profit. Accordingly, Financial Accounting Standards Board statements, Accounting Principles Board opinions, accounting research bulletins and other authoritative pronouncements of the accounting profession should be applied in determining generally accepted accounting principles unless such statements, opinions, bulletins and pronouncements are inapplicable. Section 510.05 of the AICPA Professional Standards, in and of itself, shall not be sufficient reason for determining inapplicability of statements, opinions, bulletins and pronouncements.

(m) Workers' compensation health care provider organization” or “organization” means an entity authorized by the Administrative Director to be a health care organization pursuant to Section 4600.5(e) and 4600.6, or an entity applying for such authorization.

NOTE

Authority cited: Stats. 1997, Ch. 346, Section 5. Reference: Sections 4600.3, 4500.5 and 4600.6, Labor Code.

HISTORY

1. New section filed 4-15-98; operative 4-15-98. Submitted to OAL for printing only pursuant to Stats. 1997, Ch. 346, Section 5 (Register 98, No. 16).