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 1 - Application and Enrollment › Section 51000.45 - Provider Agreement

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
An applicant or provider shall sign and submit one of the
						following provider agreements, as applicable:
(a) "Medi-Cal Provider Agreement," DHS 6208
					 (Rev. 05/05), incorporated by reference herein.
(b) "Medi-Cal Physician
					 Application/Agreement," DHS 6210 (Rev. 07/05), incorporated by reference
					 herein.
(c) "Medi-Cal Rendering
					 Provider Application/Disclosure Statement/Agreement for Physician/Allied/Dental
					 Providers," DHCS 6216 (Rev. 2/15) incorporated by reference herein.
(d) "Drug Medi-Cal Provider Agreement," DHCS
					 6009 (Rev. 12/14), incorporated by reference herein.
(e) "Drug Medi-Cal Substance Use Disorder
					 Medical Director/Licensed Substance Use Disorder Treatment
					 Professional/Substance Use Disorder Nonphysician Medical Practitioner
					 Application/Agreement/Disclosure Statement," DHCS 6010 (Rev. 12/14).
1. New
						section 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						emergency language will be repealed by operation of law on the following day.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).
2. New section, including amendments, 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						be repealed by operation of law on the following day.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).
3. New section 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						transmitted to OAL by 9-19-2000 or emergency language will be repealed by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.
4. New section 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						language will be repealed by operation of law on the following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.
5. Certificate of Compliance as to 8-28-2000 order, including
						amendment of section and NOTE, transmitted to OAL 12-26-2000 and filed 2-8-2001
						(Register 2001, No. 6).
6. Amendment filed 2-3-2003 as an emergency;
						operative 2-3-2003 (Register 2003, No. 6). Emergency amendments exempt from OAL
						review pursuant to Welfare and Institutions Code section
						14043.75.
						Amendments to remain in effect for 180 days pursuant to section
						78, chapter 146, Statutes of 1999
						(AB 1107). A Certificate of Compliance must be transmitted to OAL by 8-4-2003
						or emergency language will be repealed by operation of law on the following
						day.
7. Amendment refiled 8-5-2003 as an emergency; operative
						8-5-2003 (Register 2003, No. 32). Emergency amendments exempt from OAL review
						pursuant to Welfare and Institutions Code section
						14043.75.
						Amendments to remain in effect for 180 days pursuant to section
						78, chapter 146, Statutes of 1999
						(AB 1107). A Certificate of Compliance must be transmitted to OAL by 2-2-2004
						or emergency language will be repealed by operation of law on the following
						day.
8. Amendment refiled 2-3-2004 as an emergency; operative
						2-3-2004 (Register 2004, No. 6). Emergency amendments exempt from OAL review
						pursuant to Welfare and Institutions Code section
						14043.75.
						A Certificate of Compliance must be transmitted to OAL by 6-2-2004 or emergency
						language will be repealed by operation of law on the following
						day.
9. Reinstatement of section as it existed prior to 2-3-2004
						emergency amendment by operation of Government Code section
						11346.1(f)
						(Register 2004, No. 24).
10. Amendment refiled 6-8-2004 as an
						emergency; operative 6-8-2004 (Register 2004, No. 24). A Certificate of
						Compliance must be transmitted to OAL by 10-6-2004 or emergency language will
						be repealed by operation of law on the following day.
11.
						Reinstatement of section as it existed prior to 6-8-2004 emergency amendment by
						operation of Government Code section
						11346.1(f)
						(Register 2004, No. 41).
12. Amendment of section 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.
13.
						Amendment of section 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.
14.
						Amendment of section 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.
15.
						Certificate of Compliance as to 6-2-2005 order, including further amendment of
						section. transmitted to OAL 9-29-2005 and filed 11-10-2005 (Register 2005, No.
						45).
16. Amendment of subsection (c), new subsections (d)-(e) and
						amendment of 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.
17. 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
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14043.2,
						  14043.25
						  and
						  14123.25(a),
						  Welfare and Institutions Code;
						  42 U.S.C. Sections
						  1320a-3,
						  1320a-7,
						  1396a(a)(38),
						  1396b(i)(2); and
						  42 Code of Federal Regulations
						  Parts 431 and 455.