Health and Safety Code section 127456

(a)

The period described in Section 127455 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 emergency physician about the progress of any pending appeals.

(b)

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

(1)

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.

(2)

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

(3)

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

(4)

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

Source: Section 127456, https://leginfo.­legislature.­ca.­gov/faces/codes_displaySection.­xhtml?lawCode=HSC§ionNum=127456.­ (accessed May 19, 2025).

Last Updated

May 12, 2025

§ 127456’s source at ca​.gov