Health and Safety Code section 1371.36

(a)

A health care service plan shall not deny payment of a claim on the basis that the plan, medical group, independent practice association, or other contracting entity did not provide authorization for health care services that were provided in a licensed acute care hospital and that were related to services that were previously authorized, if all of the following conditions are met:

(1)

It was medically necessary to provide the services at the time.

(2)

The services were provided after the plan’s normal business hours.

(3)

The plan does not maintain a system that provides for the availability of a plan representative or an alternative means of contact through an electronic system, including voicemail or electronic mail, whereby the plan can respond to a request for authorization within 30 minutes of the time that a request was made.

(b)

This section shall not apply to investigational or experimental therapies, or other noncovered services.

Source: Section 1371.36, https://leginfo.­legislature.­ca.­gov/faces/codes_displaySection.­xhtml?lawCode=HSC§ionNum=1371.­36.­ (accessed May 12, 2025).

1367
 1367.01
 1367.001
 1367.1
 1367.02
 1367.002
 1367.2
 1367.03
 1367.003
 1367.3
 1367.004
 1367.04
 1367.4
 1367.005
 1367.5
 1367.05
 1367.006
 1367.6
 1367.06
 1367.007
 1367.07
 1367.7
 1367.008
 1367.08
 1367.8
 1367.009
 1367.09
 1367.9
 1367.010
 1367.10
 1367.012
 1367.12
 1367.015
 1367.15
 1367.016
 1367.18
 1367.19
 1367.20
 1367.21
 1367.22
 1367.23
 1367.24
 1367.25
 1367.27
 1367.28
 1367.29
 1367.30
 1367.031
 1367.31
 1367.32
 1367.33
 1367.34
 1367.035
 1367.35
 1367.36
 1367.37
 1367.38
 1367.39
 1367.041
 1367.41
 1367.042
 1367.42
 1367.043
 1367.43
 1367.045
 1367.45
 1367.46
 1367.47
 1367.49
 1367.50
 1367.51
 1367.54
 1367.0061
 1367.61
 1367.62
 1367.63
 1367.64
 1367.65
 1367.66
 1367.67
 1367.68
 1367.69
 1367.71
 1367.0085
 1367.205
 1367.206
 1367.207
 1367.215
 1367.241
 1367.243
 1367.244
 1367.251
 1367.255
 1367.624
 1367.625
 1367.626
 1367.627
 1367.635
 1367.656
 1367.665
 1367.667
 1367.668
 1367.695
 1368
 1368.01
 1368.1
 1368.02
 1368.2
 1368.03
 1368.04
 1368.05
 1368.5
 1368.7
 1368.015
 1368.016
 1368.017
 1369
 1370
 1370.1
 1370.2
 1370.4
 1370.6
 1371
 1371.1
 1371.2
 1371.3
 1371.4
 1371.5
 1371.8
 1371.9
 1371.22
 1371.25
 1371.30
 1371.31
 1371.34
 1371.35
 1371.36
 1371.37
 1371.38
 1371.39
 1371.51
 1371.55
 1371.56
 1372
 1373
 1373.1
 1373.2
 1373.3
 1373.4
 1373.5
 1373.6
 1373.7
 1373.8
 1373.9
 1373.10
 1373.11
 1373.12
 1373.13
 1373.14
 1373.18
 1373.19
 1373.20
 1373.21
 1373.65
 1373.95
 1373.96
 1373.620
 1373.621
 1373.622
 1374
 1374.1
 1374.3
 1374.5
 1374.7
 1374.8
 1374.9
 1374.10
 1374.11
 1374.12
 1374.13
 1374.14
 1374.15
 1374.16
 1374.17
 1374.18
 1374.19
 1374.51
 1374.55
 1374.56
 1374.57
 1374.58
 1374.75
 1374.141
 1374.142
 1374.192
 1374.193
 1374.194
 1374.195
 1374.196
 1374.197
 1374.551
Last Updated

May 12, 2025

§ 1371.36’s source at ca​.gov