Pursuant to California Health & Safety Code section 1262.8, Central California Alliance for Health (the Alliance) is required to provide notification to all non-contracting hospitals in the state to which one of its members would be transferred, with specific contact information needed for the facility to notify the health plan of the need for post-stabilization care under section 1262.8 or a transfer for admission to relieve or eliminate a psychiatric emergency medical condition under section 1317.4a.
If an Alliance member in your care has an emergency medical condition (as defined by Health & Safety Code 1317.1(b)) and needs post-stabilization care, or has a psychiatric emergency medical condition (as defined by Health & Safety Code 1317.1(k)) requiring a transfer for admission to a hospital psychiatric unit or acute psychiatric hospital for care or treatment necessary to relieve or eliminate a psychiatric emergency medical condition, it is requested that the attending physician/hospital meet the following obligations:
- Notify the PCP immediately.
- Notify the Alliance within 24 hours or on the next business day and obtain eligibility verification and authorization for the admission at 831-430-5506 o 800-700-3874, ext. 5506.
- For after-hours authorization of post-stabilization requests, the provider should contact the on-call Alliance medical director at 831-429-7484, available 24 hours a day.
Upon receipt of a post-stabilization authorization request from an emergency services provider, the Alliance will render a decision within 30 minutes, or the request is deemed approved, pursuant to Title 28 CCR Section 1300.71.4.
Non-contracted hospitals will either be provided with authorization to provide post-stabilization care, or the UM Department will arrange for transportation to a contracted facility.