Ins. Code, § 12693.55 · Chapter 4. Administration
Ins. Code, § 12693.55
Text — As published in the Legislative Counsel's database, tables dated October 18, 2026 (pubinfo_2025.zip)
(a) A health care provider who is furnished documentation of a person’s enrollment in the program shall not seek reimbursement nor attempt to obtain payment for any covered services provided to that person other than from the participating health plan covering that person or from other entities that the board enters into contracts or interagency agreements with to provide or pay for benefits under this part pursuant to Section 12693.26.
(b) The provisions of subdivision (a) do not apply to any copayments required under this part for the covered services provided to the person.
(c) For purposes of this section, “health care provider” means any professional person, organization, health facility, or other person or institution licensed by the state to deliver or furnish health care services.
Notes and commentary — not statutory text
History
Amended by Stats. 2011, Ch. 29, Sec. 1. (AB 102) Effective June 29, 2011.
Source of truth
- Edition
- As published in the Legislative Counsel's database, tables dated October 18, 2026 (pubinfo_2025.zip)
- Official file
- https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=INS§ionNum=12693.55.
- Text hash
- sha256 1b6cf9c863636a077c1f19112990e6893d2bfa429f6263f68bc526a63efae6da
- Composed by
- compose_ca.py 2026-10-22: the Legislative Counsel's CAML content files read by a tokenizer (caml_readers.reader_a); an independent xml.etree reading (caml_readers.reader_b) agrees on every section
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Insurance Code
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