Welfare and Institutions Code section 5964
(a)
(1)The State Department of Health Care Services may impose a plan of correction or assess civil money penalties pursuant to paragraph (2), or both, against a specified entity licensed or certified by the State Department of Health Care Services that fails to submit data accurately, timely, or as required pursuant to Section 131425 of the Health and Safety Code.(2)
The State Department of Health Care Services may determine a reasonable length of time for the facility to complete a plan of correction. The State Department of Health Care Services may issue a notice of imposition of civil money penalties if the facility fails to complete a plan of correction by the time specified. The State Department of Health Care Services may assess penalties against a facility in the amount of one hundred dollars ($100) per day from the date of notice of imposition of penalties.(3)
A facility may submit a written grievance to the State Department of Health Care Services within 15 working days of the issuance of the notice specified in paragraph (2). The facility shall include any supporting documentation and explain any mitigating circumstances. The State Department of Health Care Services shall make a determination on the grievance within 90 calendar days of receipt of a complete grievance.(4)
A facility may request a formal hearing within 30 calendar days of the State Department of Health Care Services’ determination on the grievance pursuant to paragraph (3). Hearings to review the imposition of civil money penalties shall be conducted pursuant to the requirements set forth in Section 100171 of the Health and Safety Code. Civil money penalties against a facility shall continue to accrue until the effective date of the final decision of the State Department of Health Care Services.(5)
The State Department of Health Care Services may obtain a court order to recover unpaid civil money penalties against a specified entity licensed or certified by the State Department of Health Care Services.(b)
Notwithstanding Section 13340 of the Government Code, civil money penalties collected pursuant to this section shall be deposited into the General Fund for use, upon appropriation by the Legislature, for costs for behavioral health care services furnished to persons eligible for the Medi-Cal program, including persons dually eligible for the Medi-Cal program and the Medicare Program.(c)
The State Department of Health Care Services shall seek any federal approvals it deems necessary to implement this section. This section shall be implemented only to the extent that any necessary federal approvals are obtained and federal financial participation is available and is not otherwise jeopardized.(d)
Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the State Department of Health Care Services may implement, interpret, or make specific this section, in whole or in part, by means of information notices, provider bulletins, or other similar instructions, without further regulatory action.(e)
For purposes of this section, “specified entity” has the same meaning as defined in Section 131400 of the Health and Safety Code.
Source:
Section 5964, https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=5964.
(accessed Apr. 24, 2025).