Added by Stats. 2006, Ch. 755, Sec. 1. Effective January 1, 2007.
(a)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.
(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.
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