Compliance and Regulations

Provider Type

  • Physicians 
  • Hospitals
  • Ancillary

Compliance with InterQual Guidelines

Participating providers must comply with InterQual guidelines. California Correctional Health Care Services (CCHCS) may conduct an inspection and evaluation of participating provider's offices to determine compliance with InterQual guidelines, scheduling requirements and medical treatments. CCHCS has the right not to use participating providers if they are found to be non-compliant with CCHCS requirements. CCHCS does not pay for services performed by participating providers which are deemed unacceptable.

Communicable Diseases

To protect the public from the spread of infectious, contagious and communicable disease, every health care provider knowing of or in attendance on a case or suspected case of any of the communicable diseases and conditions specified in Title 17, California Code of Regulations (CCR), Section 2500 and 2505, are required by law to notify the local health department (LHD) and/or the California Department of Public Health. A health care provider having knowledge of a case of an unusual disease not listed must also promptly report the facts to the local health officer.

Results must also be communicated to the institution Chief Executive Officer/Chief Support Executive (CEO/CSE) or Physician and Surgeon (P&S), or the Department of Juvenile Justice (DJJ)* Chief Medical Officer (CMO) within two business days, or as required by disease or condition.

The term "health care provider" includes physicians and surgeons, veterinarians, podiatrists, nurse practitioners, physician assistants, registered nurses, nurse midwives, school nurses, infection control practitioners, medical examiners, coroners, and dentists.


Reports of cases of communicable diseases must be made using the Confidential Morbidity Report

The notification must include the following, if known:

  • Name of the disease or condition being reported.
  • The date of onset.
  • The date of diagnosis.
  • The patient name, race or ethnic group, Social Security number (SSN), age, gender, and date of birth for the case or suspected case.
  • The date of death, if death has occurred.
  • The name, address and phone number of the person making the report.

*As of June 30, 2023, all Divisions of Juvenile Justice (DJJ) are closed. Juvenile offenders are no longer committed to the DJJ as of this date. Effective July 1, 2023, claims for health care services rendered to the DJJ youth should be directed to the county where the patient is located. Claims for services rendered on or prior to June 30, 2023, will continue to be the responsibility of California Department of Corrections and Rehabilitation (CDCR).