California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 2 - Definitions › Section 51051 - Provider

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) "Provider"
					 means any individual, partnership, group, association, corporation,
					 institution, or entity, and the officers, directors, owners, managing
					 employees, or agents of any partnership, group association, corporation,
					 institution, or entity, that provides services, goods, supplies, or
					 merchandise, directly or indirectly, to a Medi-Cal beneficiary, and that has
					 been enrolled in the Medi-Cal program.
(b) Providers include, but are not limited
					 to:
Acupuncturists
Audiologists
Blood Banks
Child Health and Disability Prevention Providers
Chiropractors
Clinical Laboratories or Laboratories
Comprehensive Perinatal Providers
Dental School Clinics
Dentists
Dispensing Opticians
Durable Medical Equipment and Medical Supply
						Providers
Early and Periodic Screening, Diagnosis and Treatment
						(EPSDT) Providers
EPSDT Supplemental Services Providers
Fabricating Optical Laboratory
Hearing Aid Dispensers
Home Health Agencies Hospices
Hospital Outpatient Departments
Hospitals
Intermediate Care Facilities
Intermediate Care Facilities for the Developmentally
						Disabled
Licensed Midwife
Licensed Substance Use Disorder Treatment
						Professionals
Local Educational Agency Providers
Nurse Anesthetists
Nurse Midwives
Nurse Practitioners
Nursing Facilities
Occupational Therapists
Ocularists Optometrists
Orthotists
Organized Outpatient Clinics
Outpatient Heroin Detoxification Providers
Personal Care Service Providers
Pharmacies/Pharmacists
Physical Therapists
Physicians
Podiatrists
Portable Imaging Services Providers
Prosthetists
Providers of Medical Transportation
Psychologists Rehabilitation
Religious Nonmedical Health Care Institutions
Renal Dialysis Centers and Community Hemodialysis
						Units
Respiratory Care Practitioners
Rural Health Clinics
Short-Doyle Medi-Cal Providers
Skilled Nursing Facilities
Speech Therapists
Substance Use Disorder Clinics
Substance Use Disorder Medical Directors
Substance Use Disorder Nonphysician Medical
						Practitioners
Targeted Case Management Providers
1.
						Amendment of subsection (b) filed 10-27-87 as an emergency; operative 10-27-87
						(Register 87, No. 44). A Certificate of Compliance must be transmitted to OAL
						within 120 days or emergency language will be repealed on 2-24-88. For prior
						history, see Register 87, No. 38.
2. Certificate of Compliance
						transmitted to OAL 2-24-88 and filed 3-22-88 (Register 88, No.
						15).
3. Amendment filed 11-28-88 as an emergency; operative 11-28-88
						(Register 89, No. 11). A Certificate of Compliance must be transmitted to OAL
						within 120 days or emergency language will be repealed on
						3-28-89.
4. Certificate of Compliance as to 11-28-88 order
						transmitted to OAL 3-27-89 and filed 4-26-89 (Register 89, No.
						18).
5. Amendment of subsection (b) filed 10-1-90 as an emergency;
						operative 10-1-90 (Register 90, No. 45). A Certificate of Compliance must be
						transmitted to OAL by 1-29-91 or emergency language will be repealed by
						operation of law on the following day.
6. Certificate of Compliance
						as to 10-1-90 order transmitted to OAL 1-29-91 and filed 2-28-91 (Register 91,
						No. 13).
7. Amendment of subsection (b) filed 5-24-91 as an
						emergency; operative 5-24-91 (Register 91, No. 26). A Certificate of Compliance
						must be transmitted to OAL by 9-23-91 or emergency language will be repealed by
						operation of law on the following day.
8. Amendment of subsection
						(b) filed 4-14-93 as an emergency; operative 4-14-93. Submitted to OAL for
						printing only pursuant to section
						8, AB 1773 (Chapter 939, Statutes
						of 1992) (Register 93, No. 16).
9. Amendment of subsection (b)
						adding Local Educational Agency Providers filed 12-22-93 as an emergency;
						operative 12-22-93 (Register 93, No. 52). A Certificate of Compliance must be
						transmitted to OAL by 4-22-94 or emergency language will be repealed by
						operation of law on the following day.
10. Amendment of subsection
						(b) and NOTE filed 1-20-94 as an emergency; operative 1-20-94 (Register 94, No.
						3). A Certificate of Compliance must be transmitted to OAL by 5-20-94 or
						emergency language will be repealed by operation of law on the following
						day.
11. Amendment of subsection (b) adding Early and Periodic
						Screening, Diagnosis and Treatment, and Supplemental EPSDT Providers filed
						4-4-94 as an emergency; operative 4-4-94 (Register 94, No. 14). A Certificate
						of Compliance must be transmitted to OAL by 8-2-94 or emergency language will
						be repealed by operation of law on the following day.
12.
						Certificate of Compliance as to 12-22-93 order transmitted to OAL 4-20-94 and
						filed 6-2-94 (Register 94, No. 22).
13. Certificate of Compliance as
						to 1-20-94 order transmitted to OAL 5-19-94 and filed 7-1-94 (Register 94, No.
						26).
14. Amendment of subsection (b) adding Early and Periodic
						Screening, Diagnosis and Treatment and Supplemental EPSDT Providers refiled
						8-1-94 as an emergency; operative 8-1-94 (Register 94, No. 31). A Certificate
						of Compliance must be transmitted to OAL by 11-29-94 or emergency language will
						be repealed by operation of law on the following day.
15. Amendment
						of subsection (b) adding Early and Periodic Screening, Diagnosis and Treatment
						and Supplemental EPSDT Providers refiled 10-24-94 as an emergency; operative
						10-24-94 (Register 94, No. 43). A Certificate of Compliance must be transmitted
						to OAL by 2-21-95 or emergency language will be repealed by operation of law on
						the following day.
16. Amendment of subsection (b) adding Early and
						Periodic Screening, Diagnosis and Treatment and Supplemental EPSDT Providers
						refiled 2-22-95; operative 2-22-95 (Register 95, No. 8). A Certificate of
						Compliance must be transmitted to OAL by 6-22-95 or emergency language will be
						repealed by operation of law on the following day.
17. Certificate
						of Compliance as to 2-22-95 order including amendment of section transmitted to
						OAL 3-16-95 and filed 4-27-95 (Register 95, No. 17).
18. Amendment
						of subsection (b) and NOTE filed 7-1-96; operative 7-1-96. Submitted to OAL for
						printing only pursuant to Section
						6, Chapter 305, Statutes of 1995
						(Register 96, No. 27).
19. Amendment of subsection (b) and NOTE
						refiled 10-29-96 as an emergency; operative 10-29-96 (Register 96, No. 44).
						Submitted to OAL for printing only pursuant to Section
						6, Chapter 305, Statutes of 1995.
						A Certificate of Compliance must be transmitted to OAL by 2-26-97 or emergency
						language will be repealed by operation of law on the following
						day.
20. Editorial correction of HISTORY 19 (Register 97, No.
						15).
21. Reinstatement of subsection (b) and NOTE as they existed
						prior to emergency amendment filed 7-1-96 by operation of Government Code
						section
						11346.1(f)
						(Register 97, No. 15).
22. Amendment of subsection (b) and NOTE
						filed 4-10-97; operative 4-10-97 pursuant to Government Code section
						11343.4(d)
						(Register 97, No. 15).
23. Amendment of subsection (b) filed
						6-23-97; operative 7-23-97 (Register 97, No. 26).
24. Amendment of
						subsection (b) filed 8-10-99 as an emergency; operative 8-10-99 (Register 99,
						No. 33). A Certificate of Compliance must be transmitted to OAL by 12-8-99 or
						emergency language will be repealed by operation of law on the following
						day.
25. Amendment of section heading, section and NOTE filed
						9-28-99 as an emergency; operative 9-28-99 (Register 99, No. 40). A Certificate
						of Compliance must be transmitted to OAL by 3-27-2000 or emergency language
						will be repealed by operation of law on the following day. Submitted to OAL for
						printing only pursuant to section
						78, AB 1107 (Chapter 146, Statutes
						of 1999).
26. Amendment of section heading, section and NOTE refiled
						11-24-99 as an emergency; operative 11-24-99 (Register 99, No. 48). A
						Certificate of Compliance must be transmitted to OAL by 5-22-2000 or emergency
						language will be repealed by operation of law on the following day. Submitted
						to OAL for printing only pursuant to section
						78, AB 1107 (Chapter 146, Statutes
						of 1999).
27. Certificate of Compliance as to 8-10-99 order
						transmitted to OAL 12-7-99 and filed 1-14-2000 (Register 2000, No.
						2).
28. Amendment of section heading, section and NOTE refiled
						5-5-2000 as an emergency; operative 5-22-2000 (Register 2000, No. 18). A
						Certificate of Compliance must be transmitted to OAL by 9-19-2000 or emergency
						language will be repealed by operation of law on the following
						day.
29. Amendment of section heading, section and NOTE refiled
						8-28-2000 as an emergency; operative 9-6-2000 (Register 2000, No. 35). A
						Certificate of Compliance must be transmitted to OAL by 1-4-2001 or emergency
						language will be repealed by operation of law on the following
						day.
30. Amendment of subsection (b) and amendment of NOTE filed
						10-24-2000 as an emergency and submitted to OAL for printing only pursuant to
						Section 78, Chapter 146, Statutes of 1999;
						operative 10-24-2000 (Register 2000, No. 43). A Certificate of Compliance must
						be transmitted to OAL by 4-23-2001 or emergency language will be repealed by
						operation of law on the following day.
31. Certificate of Compliance
						as to 8-28-2000 order transmitted to OAL 12-26-2000 and filed 2-8-2001
						(Register 2001, No. 6).
32. Editorial correction of HISTORY 30
						(Register 2001, No. 14).
33. Amendment of subsection (b) and
						amendment of NOTE refiled 4-4-2001 as an emergency and submitted to OAL for
						printing only pursuant to Section
						78, Chapter 146, Statutes of 1999;
						operative 4-4-2001 (Register 2001, No. 14). A Certificate of Compliance must be
						transmitted to OAL by 8-2-2001 or emergency language will be repealed by
						operation of law on the following day.
34. Certificate of Compliance
						as to 4-4-2001 order transmitted to OAL 7-31-2001 and filed 9-5-2001 (Register
						2001, No. 36).
35. Amendment of subsection (b) and amendment of NOTE
						filed 9-3-2004; operative 10-3-2004 (Register 2004, No. 36).
36.
						Amendment of subsection (a) and NOTE filed 9-29-2004 as an emergency; operative
						10-7-2004 (Register 2004, No. 41). A Certificate of Compliance must be
						transmitted to OAL by 2-4-2005 or emergency language will be repealed by
						operation of law on the following day. Deemed emergency exempt from OAL
						pursuant to Welfare and Institutions Code section
						14043.75.
37.
						Amendment of subsection (a) and NOTE refiled 1-27-2005 as an emergency;
						operative 2-5-2005 (Register 2005, No. 4). A Certificate of Compliance must be
						transmitted to OAL by 6-6-2005 or emergency language will be repealed by
						operation of law on the following day. Deemed emergency exempt from OAL review
						pursuant to Welfare and Institutions Code section
						14043.75.
38.
						Amendment of subsection (a) and NOTE refiled 6-2-2005 as an emergency;
						operative 6-7-2005 (Register 2005, No. 22). A Certificate of Compliance must be
						transmitted to OAL by 10-5-2005 or emergency language will be repealed by
						operation of law on the following day. Deemed emergency exempt from OAL review
						pursuant to Welfare and Institutions Code section
						14043.75.
39.
						Certificate of Compliance as to 6-2-2005 order, including further amendment of
						subsection (a), transmitted to OAL 9-29-2005 and filed 11-10-2005 (Register
						2005, No. 45).
40. Change without regulatory effect amending
						subsection (b) filed 10-8-2014 pursuant to section
						100, title 1, California Code of
						Regulations (Register 2014, No. 41).
41. Amendment of subsection (b)
						and amendment of NOTE filed 5-12-2015; operative 7-1-2015 (Register 2015, No.
						20).
42. Amendment of section and NOTE filed 8-17-2015 as a deemed
						emergency exempt from OAL review pursuant to Welfare and Institutions Code
						section
						14043.75;
						operative 8-17-2015 (Register
						2015,
						No. 34). A Certificate of Compliance must be transmitted to OAL by 2-16-2016 or
						emergency language will be repealed by operation of law on the following
						day.
43. Certificate of Compliance as to 8-17-2015 order transmitted
						to OAL 12-30-2015 and filed 2-11-2016 (Register 2016, No.
						7).
Note: Authority cited: Section
						  20, Health and Safety Code;
						  Sections
						  10725,
						  14043.75,
						  14100.1,
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14043,
						  14043.1,
						  14043.15,
						  14043.26,
						  14043.27,
						  14043.36,
						  14100.1,
						  14105,
						  14105.3,
						  14115.6,
						  14124.5,
						  14132,
						  14132.39,
						  14132.4,
						  14132.44
						  and
						  14134.5,
						  Welfare and Institutions Code; Section
						  33, Chapter 456, Statutes of 1990;
						  Section
						  1250(k),
						  Health and Safety Code; Section
						  1206,
						  Business and Professions Code; and Title
						  42 United States Code,
						  Section
						  263a.