Article 6 - Eligibility for Payment

  1. § 51451 - Inclusions, Exclusions and Suspensions
  2. § 51452 - Violation of Regulations, Administrative Sanctions
  3. § 51453 - Recommendation for Suspension
  4. § 51454 - Provider Defined
  5. § 51454.1 - Provider of Personal Care Services Defined
  6. § 51455 - Prior Authorization
  7. § 51456 - Signing Treatment Authorization Requests
  8. § 51457 - Administrative Action. [Repealed]
  9. § 51458 - Cause for Suspension
  10. § 51458.1 - Cause for Recovery of Provider Overpayments
  11. § 51458.2 - Statistical Extrapolation of Medi-Cal Provider Reviews
  12. § 51459 - Reinstatement
  13. § 51460 - Special Claims Review
  14. § 51461 - Orders for Suspension or Placement on Prior Authorization. [Repealed]
  15. § 51463 - Requests for Hearing. [Repealed]
  16. § 51464 - When Hearing Not Requested. [Repealed]
  17. § 51465 - Review by the Director. [Repealed]
  18. § 51466 - Disclosure of Significant Beneficial Interest
  19. § 51466.1 - Significant Beneficial Interest. [Repealed]
  20. § 51467 - Advertising. [Repealed]
  21. § 51469 - Decertification. [Repealed]
  22. § 51470 - Billing for Benefits Provided
  23. § 51471 - Seeking Reimbursement from Beneficiaries. [Repealed]
  24. § 51471.1 - Reimbursements for Program Underpayments
  25. § 51472 - Sub-Standard Services
  26. § 51473 - Excessive Services
  27. § 51473.1 - Referral for Excessive Services
  28. § 51473.2 - Services to Children
  29. § 51474 - False Advertising. [Repealed]
  30. § 51475 - Refusal to Render Services. [Repealed]
  31. § 51476 - Keeping and Availability of Records
  32. § 51476.1 - Pharmacy and Clinic with Special Permit Records of Pharmaceutical Services
  33. § 51476.2 - Personal Care Services Records
  34. § 51477 - Confidential Beneficiary Information. [Repealed]
  35. § 51478 - Prohibition of Rebate, Refund, or Discount
  36. § 51479 - Change of Order or Prescription
  37. § 51480 - Discriminatory Billings
  38. § 51481 - Forbidden Conduct
  39. § 51482 - Unwarranted Inpatient Discharge
  40. § 51483 - Provider Requirements
  41. § 51483.1 - Personal Care Provider Requirements
  42. § 51484 - Billing for Suspended Provider
  43. § 51485 - Submission of False Information
  44. § 51485.1 - Civil Money Penalties
  45. § 51486 - Medi-Cal Card Labels
  46. § 51487 - Examinations of Beneficiaries
  47. § 51488 - Pharmaceutical Postservice -Postpayment On-Site Reviews Including Clinics with Special Permits
  48. § 51488.1 - Pharmaceutical Recovery Standards Including Clinics with Special Permits
  49. § 51488.2 - Statistical Extrapolation for Medi-Cal Pharmacy Reviews
  50. § 51488.3 - Underpayment Adjustments to Medi -Cal Reviews of Pharmacies and Clinics With Special Permits
  51. § 51488.4 - Adjustments to Medi-Cal Pharmacy and Clinic with a Special Permit Reviews for Unsubmitted Claims
  52. § 51489 - Eligibility for Payment for Paramedic Ambulance Services. [Repealed]
  53. § 51490 - Claim Submission Requirements for Short-Doyle Medi-Cal Providers
  54. § 51490.1 - Claim Submission Requirements for Counties and Providers of Drug Medi-Cal Substance Use Disorder Services
  55. § 51491 - Local Educational Agency (LEA) Eligibility for Payment
  56. § 51492 - Claim Submission Requirements for Targeted Case Management Providers
  57. § 51492.1 - Host County Contractual Responsibilities in the Targeted Case Management Program. [Repealed]
  58. § 51492.2 - Participation Fee Requirements in the Targeted Case Management Program

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