§ 97300. Definitions.
22 CA ADC § 97300Barclays Official California Code of RegulationsEffective: November 17, 2023
Effective: November 17, 2023
22 CCR § 97300
§ 97300. Definitions.
The following definitions shall apply to the regulations contained in this Chapter:
(1) For monthly data files submitted or resubmitted pursuant to this Chapter on or before February 16, 2024, the Common Data Layout for All-Payer Claims Databases, Version 2.1, released July 1, 2021, as developed by the University of New Hampshire and the National Association of Health Data Organizations (NAHDO), and hereby incorporated by reference. This document is available through the APCD Council website; or
(2) For monthly data files submitted or resubmitted pursuant to this Chapter on or after February 17, 2024, the Common Data Layout for All-Payer Claims Databases, Version 3.0.1, released April 1, 2023, as developed by the University of New Hampshire and NAHDO, and hereby incorporated by reference. This document is available through the APCD Council website.
(1) For registrations and monthly data files submitted or resubmitted pursuant to this Chapter on or before February 16, 2024, the Health Care Payments Data Program: Data Submission Guide, Version 1.0, dated November 23, 2021, and hereby incorporated by reference. The Data Submission Guide is available on, and may be downloaded from, the Department's website; or
(2) For registrations and monthly data files submitted or resubmitted pursuant to this Chapter on or after February 17, 2024, the Health Care Payments Data Program: Data Submission Guide, Version 2.0, revised on July 17, 2023, and hereby incorporated by reference. The Data Submission Guide is available on, and may be downloaded from, the Department's website.
(j) “Health insurer” means an insurer licensed to provide health insurance, as defined in Section 106 of the Insurance Code, and an insurer offering specialized health insurance offering pharmacy, behavioral health (psychological), or dental services. Insurers providing only other specialized health insurance, or stop-loss insurance, student health insurance, supplemental insurance (including Medicare supplemental insurance), or discount-only insurance, are not considered health insurers.
(k) “Health plan” means a health care service plan as defined in the Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2 (commencing with Section 1340) of Division 2 of the Health and Safety Code) or a specialized health care service plan offering pharmacy, behavioral health (psychological), or dental services. “Health plan” does not include a health care service plan that holds a restricted or limited license only under the Knox-Keene Health Service Plan Act of 1975. Student health plans and supplemental plans (including Medicare supplemental coverage) are not considered health plans.
Credits
Note: Authority cited: Section 127673, Health and Safety Code. Reference: Sections 127671, 127671.1, 127673, 127673.1 and 127673.2, Health and Safety Code.
History
1. New chapter 11 (articles 1-7, sections 97300-97370), article 1 (section 97300) and section filed 12-20-2021 as an emergency; operative 12-20-2021 (Register 2021, No. 52). Pursuant to Health and Safety Code section 12763(f), a Certificate of Compliance must be transmitted to OAL by 12-20-2023 or emergency language will be repealed by operation of law on the following day. For prior history of chapter 11, see Register 87, No. 15.
2. Certificate of Compliance as to 12-20-2021 order, including amendment of subsections (a)-(a)(1), new subsection (a)(2), amendment of subsections (c)-(c)(1) and new subsection (c)(2) transmitted to OAL 10-13-2023 and filed 11-17-2023; amendments effective 11-17-2023 pursuant to Government Code section 11343.4(b)(3) (Register 2023, No. 46).
This database is current through 4/26/24 Register 2024, No. 17.
Cal. Admin. Code tit. 22, § 97300, 22 CA ADC § 97300
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