To ensure continuity of care within the California Department of Corrections and Rehabilitation (CDCR) institution, providers must furnish all clinical documentation to California Correctional Health Care Services (CCHCS) within 48 hours of a patient office visit. Clinical documentation includes, but is not limited to prescriptions, clinical notes, discharge summaries, and brief operative notes.

Network Providers, LLC (NPLLC) and its participating providers do not discriminate against CDCR patients who have physical disabilities. Participating providers are required to provide reasonable access for disabled patients in accordance with the Americans with Disabilities Act of 1990 (ADA).

Participating providers and hospitals must notify Network Providers, LLC (NPLLC) in writing at least 90 days prior to terminating their relationship with NPLLC (or as stated in their Provider Participation Agreement (PPA) ). NPLLC offers transition of care assistance to patients who request to complete a course of treatment of covered services by a terminated provider.

The California Department of Corrections and Rehabilitation (CDCR) notifies participating providers of CDCR patients' or Division of Juvenile Justice (DJJ)* youths' primary language, primary method of communication and interpreter service requirements when appointments are scheduled. At the time the appointment is scheduled, providers must inform CDCR if required interpreter services cannot be provided. If interpreter services are not available, California Correctional Health Care Services (CCHCS) provides an interpreter at no cost to the provider.

*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).

Participating providers must immediately notify the institution chief executive officer/chief medical executive/chief medical officer (CEO/CME/CMO) or designee in the event of a CDCR patient, Parole Agent or UM team for a medical parolee, or facility chief medical officer (FCMO) for a Department of Juvenile Justice (DJJ)* youth death while under their care or in the hospital. The attending provider(s) will discuss with the Institution CEO/CME or designee and/or the DJJ* FCMO, or their designee the appropriateness/need for a post-mortem. Both parties shall mutually agree upon the decision for an autopsy, prior to or in conjunction with the coroner’s office. The coroner’s office has the final decision on whether an autopsy is necessary.

*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).

Providers performing hospital services must issue a written discharge summary and/or transfer summary, upon hospital discharge of a patient back to the appropriate California Department of Corrections and Rehabilitation (CDCR) institution, a medical parolee back to the appropriate skilled nursing facility or a Department of Juvenile Justice (DJJ)* youth back to the appropriate DJJ* facility. Providers must give the CDCR institution’s health care manager (HCM), chief executive officer (CEO), chief medical executive (CME), or representative and/or the DJJ* facility chief medical officer (FCMO), or their designee, a full, dictated or written formal discharge summary within three days of the discharge of a patient in all cases. The discharge summary and/or transfer summary must include the staff physician’s recommendations for continuance of care for the patient. The discharge or transfer summary precedes or accompanies the CDCR patient1 when discharged. The discharge and transfer summary must be signed by a physician and include the following essential information:

California Correctional Health Care Services (CCHCS) may request hospital providers to use a standardized discharge summary form, created by CCHCS. In the event labs or other test results are pending when discharge summaries are issued, providers must provide an updated report within 24 hours of receipt for labs or test results. Upon request, network hospitals must grant CCHCS clinical staff access to hospital medical records systems, if feasible.

*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).

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