1399.900. (a) For the purposes of this chapter, “disease management organization” means an entity that provides disease management programs and services and that contracts with any of the following: (1) A health care service plan. (2) A contractor of a health care service plan. (3) An employer. (4) A publicly financed health care program. (5) […]
1399.901. For the purposes of this chapter, “disease management programs and services” means services administered to patients in order to improve their overall health and to prevent clinical exacerbations and complications utilizing cost-effective, evidence-based, or consensus-based practice guidelines and patient self-management strategies. Disease management programs and services shall contain all of the following: (a) A […]
1399.902. (a) Every disease management organization shall obtain physician authorization prior to the time that the disease management organization, its employees, or independent contractors do either of the following: (1) Provide home health care services utilized in the treatment of a patient. (2) Dispense, administer, or prescribe a prescription medication. (b) For purposes of this […]
1399.903. A disease management organization may receive medical information as provided in paragraph (17) of subdivision (c) of Section 56.10 of the Civil Code. However, a disease management organization shall be subject to the other provisions of the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil […]
1399.904. A disease management organization shall not use medical information obtained pursuant to Section 1399.903 to solicit or to offer for sale to a health care service plan enrollee any products or services in the provision of disease management services to the enrollee. However, an enrollee may elect to use a disease management organization to […]
