CA Health & Safety Code Section 127426


The period described in Section 127425 shall be extended if the patient has a pending appeal for coverage of the services, until a final determination of that appeal is made, if the patient makes a reasonable effort to communicate with the hospital about the progress of any pending appeals.


For purposes of this section, “pending appeal” includes any of the following:


A grievance against a contracting health care service plan, as described in Chapter 2.2 (commencing with Section 1340) of Division 2, or against an insurer, as described in Chapter 1 (commencing with Section 10110) of Part 2 of Division 2 of the Insurance Code.


An independent medical review, as described in Section 10145.3 or 10169 of the Insurance Code.


A fair hearing for a review of a Medi-Cal claim pursuant to Section 10950 of the Welfare and Institutions Code.


An appeal regarding Medicare coverage consistent with federal law and regulations.
Last Updated

Aug. 19, 2023

§ 127426’s source at ca​.gov