Cal. Code Regs. Tit. 22, § 51000.45 - Provider Agreement

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).

Notes

Cal. Code Regs. Tit. 22, § 51000.45

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 A Certificate of Compliance must be transmitted to OAL by 3-27-2000 or emergency language will be repealed by operation of law on the following day.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 A Certificate of Compliance must be transmitted to OAL by 5-22-2000 or emergency language will be repealed by operation of law on the following day.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 A Certificate of Compliance must be transmitted to OAL by 9-19-2000 or emergency language will be repealed by operation of law on the following day.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 A Certificate of Compliance must be transmitted to OAL by 1-4-2001 or emergency language will be repealed by operation of law on the following day.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.

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).