California § 14132.62 - Reconstructive surgery shall be covered under this chapter, as defined in subdivi
Full text of California Public Contract Code - PCC § 14132.62 — Reconstructive surgery shall be covered under this chapter, as defined in subdivi, with citation guidance and answers to common questions.
§ 14132.62. Reconstructive surgery shall be covered under this chapter, as defined in subdivi
(a) Reconstructive surgery shall be covered under this chapter, as defined in subdivision (c), when necessary to achieve the purposes specified in paragraphs (1) or (2) of subdivision (c). Nothing in this section shall be construed to require coverage for cosmetic surgery, as defined in subdivision (d). (b) No individual, other than a licensed physician competent to evaluate the specific clinical issues involved in the care requested, may deny initial requests for authorization of coverage for treatment pursuant to this section. For a treatment authorization request submitted by a podiatrist or an oral and maxillofacial surgeon, the request may be reviewed by a similarly licensed individual competent to evaluate the specific clinical issues involved in the care requested. (c) âReconstructive surgeryâ means surgery performed on abnormal structures of the body caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease to do either of the following: (1) To improve function. (2) To create a normal appearance, to the extent possible. (d) âCosmetic surgeryâ means surgery that is performed to alter or reshape normal structures of the body in order to improve appearance. (e) In connection with the interpretation of the definition of reconstructive surgery, a proposed surgical procedure may be subject to prior authorization and utilization review that may include, but need not be limited to, denial under any of the following circumstances: (1) There is another more appropriate surgical procedure that will be approved for the enrollee. (2) The procedure or procedures offer only a minimal improvement in the appearance of the enrollee, as defined in regulations adopted by the department. (3) Denial of payment for procedures performed without prior authorization. (f) This section shall become operative July 1, 1999.
Frequently Asked Questions About California § 14132.62
What does Public Contract Code - PCC § 14132.62 cover?
Section 14132.62 ("Reconstructive surgery shall be covered under this chapter, as defined in subdivi") is part of the Public Contract Code - PCC, the codified statutory law of California. It sets out the legal rule or procedure described in the text above. Statutes are amended regularly, so always verify against the official source.
How do I cite California § 14132.62?
A common citation format is "Public Contract Code - PCC § 14132.62" (California). Legal writing may require the code abbreviation, section number, and year or edition. Match the style required by your court, professor, or publisher.
Is this the official text of California law?
No. This page is for research and education and may not include the most recent amendments. For official current law, check the California official source linked on this page or consult a licensed California attorney.
How does California § 14132.62 apply to my situation?
Statutes are interpreted in context, and application depends on your specific facts. Only a licensed attorney in California can advise on how this section applies to you. Contact your state or local bar association for a referral.
Sources & Verification
Not legal advice. Verify against the official source and consult a licensed attorney in California.