{"data":{"id":"us-ca/hsc-1371.36","jurisdiction":"us-ca","citation":"HSC § 1371.36","heading":"","body":"(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:\n(1) It was medically necessary to provide the services at the time.\n(2) The services were provided after the plan’s normal business hours.\n(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.\n(b) This section shall not apply to investigational or experimental therapies, or other noncovered services.","path":["Health and Safety Code - HSC","DIVISION 2. LICENSING PROVISIONS [1200. - 1796.88.]","CHAPTER 2.2. Health Care Service Plans [1340. - 1399.874.]","ARTICLE 5. Standards [1367. - 1374.198.]"],"source_url":"https://downloads.leginfo.legislature.ca.gov/pubinfo_2025.zip","current_through":"2026-09-13","vintage":"","retrieved_at":"2026-09-14T05:56:33Z","sha256":"9741442198d4354ac609f81d293b149e5cf9d2525278123196c3969b370012df","source_id":"us-ca","stale":false,"prev":"us-ca/hsc-1371.35","next":"us-ca/hsc-1371.37"},"notice":"GroundRules: Original legal text. Not legal advice."}