California Health and Safety Code 1374.9 – For violations of Section 1374.7, the director may, after appropriate …
For violations of Section 1374.7, the director may, after appropriate notice and opportunity for hearing, by order, levy administrative penalties as follows:
(a) Any health care service plan that violates Section 1374.7, or that violates any rule or order adopted or issued pursuant to this section, is liable for administrative penalties of not less than five thousand dollars ($5,000) for each first violation, and of not less than ten thousand dollars ($10,000) nor more than twenty thousand dollars ($20,000) for each second violation, and of not less than thirty thousand dollars ($30,000) and not more than two hundred thousand dollars ($200,000) for each subsequent violation.
Terms Used In California Health and Safety Code 1374.9
- Director: means "State Director of Health Services. See California Health and Safety Code 21
- plan: refers to health care service plans and specialized health care service plans. See California Health and Safety Code 1345
(b) The administrative penalties shall be paid to the Managed Care Administrative Fines and Penalties Fund and shall be used for the purposes specified in Section 1341.45.
(c) The administrative penalties available to the director pursuant to this section are not exclusive, and may be sought and employed in any combination with civil, criminal, and other administrative remedies deemed advisable by the director to enforce the provisions of this chapter.
(d) Commencing January 1, 2028, and every five years thereafter, the penalty amounts specified in this section shall be adjusted based on the average rate of change in premium rates for the individual and small group markets, and weighted by enrollment, since the previous adjustment.
(Amended by Stats. 2022, Ch. 985, Sec. 2. (SB 858) Effective January 1, 2023.)