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 51000.55 - Requirements for Continued Enrollment

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The Department shall periodically
					 identify a specific provider of service category or subgroup of that category
					 that will be subject to the continued enrollment requirements of this
					 section.
(b) The Department shall
					 provide individual written notice to each of the providers in the specific
					 category or subgroup of a category that has been identified for continued
					 enrollment, and will notify those providers that they are subject to this
					 section. This notice for continued enrollment shall be mailed to the provider's
					 business address and mailing address on file with the Department.
(c) When a provider receives written notice
					 for continued enrollment pursuant to subsection (b) above, the provider shall
					 respond to the Department within 35 days from the date of the notice to declare
					 its intent to either apply for continued enrollment or to withdraw from the
					 Medi-Cal program. Providers that fail to respond to the Department within 35
					 days from the date of the notice shall be subject to termination from the
					 Medi-Cal program and deactivation of the provider's number and each business
					 address used by the provider to provide services, goods, supplies, or
					 merchandise to Medi-Cal beneficiaries.
(d) Within 180 days of receipt of a
					 declaration of a provider's intent to apply for continued enrollment in the
					 Medi-Cal program, the Department shall send a notice transmitting instructions
					 to that provider on how to apply for continued enrollment.
(e) Within 70 calendar days from the date of
					 the Department's notice pursuant to subsection (d), the provider shall submit
					 to the Department a complete application package for continued enrollment in
					 the Medi-Cal program. The Department shall review the completed application
					 package in accordance with Section
					 51000.50. Providers that fail to
					 submit to the Department a complete application package within 70 calendar days
					 from the date of the notice shall be subject to immediate termination from the
					 Medi-Cal program and deactivation of the provider's number and each business
					 address used by the provider to provide services, goods, supplies, or
					 merchandise to Medi-Cal beneficiaries.
(f) Upon receipt of a declaration of a
					 provider's intent to withdraw from enrollment in the Medi-Cal program, the
					 Department shall immediately terminate the provider's enrollment in the
					 Medi-Cal program and shall deactivate the provider's number and each business
					 address used by the provider to provide services, goods, supplies, or
					 merchandise to Medi-Cal beneficiaries.
(g) A provider may appeal the termination or
					 the deactivation pursuant to this subsection in accordance with Welfare and
					 Institutions Code, Section
					 14043.65.
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 subsection (e), 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 heading, 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 heading, 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.
						Editorial correction of subsection (d) (Register 2005, No. 22).
15.
						Amendment of section heading, 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.
16.
						Certificate of Compliance as to 6-2-2005 order transmitted to OAL 9-29-2005 and
						filed 11-10-2005 (Register
						2005,
						No. 45).
17. Change without regulatory effect amending subsection
						(c), (e) and (f) and amending NOTE filed 1-23-2009 pursuant to section
						100, title 1, California Code of
						Regulations (Register 2009, No. 4).
Note: Authority cited: Section
						  20, Health and Safety Code; and
						  Sections
						  10725,
						  14043.75
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14043.2,
						  14043.26,
						  14043.28,
						  14043.29,
						  14043.45
						  and
						  14043.7,
						  Welfare and Institutions Code.