California
GMC Plan Requirements.
22 CCR 53904
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22 CCR 53904
22 CCR 53904
§ 53904. GMC Plan Requirements.
(a)
Each GMC plan shall:
(1)
Agree to provide or arrange for the provision of, to the extent allowed by state and federal law, the scope of Medi-Cal program benefits set forth by GMC contract to eligible beneficiaries who either select or are assigned to that GMC plan.
(2)
Share in the risk of providing health care services.
(3)
Provide readily available and accessible health care services and utilize preventive health care programs to improve the health status of its members.
(4)
Case manage members' utilization of health care services.
(5)
Inform eligible beneficiaries about non-medical transportation services that may be available to them under the Medi-Cal program, including the conditions under which non-medical transportation services will be provided to members by the GMC plan and how a member is to request those services, if the plan opts to provide them.
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