Article 6. Eligibility for Payment
- § 51451. Inclusions, Exclusions and Suspensions.
- § 51452. Violation of Regulations, Administrative Sanctions.
- § 51453. Recommendation for Suspension.
- § 51454. Provider Defined.
- § 51454.1. Provider of Personal Care Services Defined.
- § 51455. Prior Authorization.
- § 51456. Signing Treatment Authorization Requests.
- § 51457. Administrative Action. [Repealed]
- § 51458. Cause for Suspension.
- § 51458.1. Cause for Recovery of Provider Overpayments.
- § 51458.2. Statistical Extrapolation of Medi-Cal Provider Reviews.
- § 51459. Reinstatement.
- § 51460. Special Claims Review.
- § 51461. Orders for Suspension or Placement on Prior Authorization. [Repealed]
- § 51463. Requests for Hearing. [Repealed]
- § 51464. When Hearing Not Requested. [Repealed]
- § 51465. Review by the Director. [Repealed]
- § 51466. Disclosure of Significant Beneficial Interest.
- § 51466.1. Significant Beneficial Interest. [Repealed]
- § 51467. Advertising. [Repealed]
- § 51469. Decertification. [Repealed]
- § 51470. Billing for Benefits Provided.
- § 51471. Seeking Reimbursement from Beneficiaries. [Repealed]
- § 51471.1. Reimbursements for Program Underpayments.
- § 51472. Sub-Standard Services.
- § 51473. Excessive Services.
- § 51473.1. Referral for Excessive Services.
- § 51473.2. Services to Children.
- § 51474. False Advertising. [Repealed]
- § 51475. Refusal to Render Services. [Repealed]
- § 51476. Keeping and Availability of Records.
- § 51476.1. Pharmacy and Clinic with Special Permit Records of Pharmaceutical Services.
- § 51476.2. Personal Care Services Records.
- § 51477. Confidential Beneficiary Information. [Repealed]
- § 51478. Prohibition of Rebate, Refund, or Discount.
- § 51479. Change of Order or Prescription.
- § 51480. Discriminatory Billings.
- § 51481. Forbidden Conduct.
- § 51482. Unwarranted Inpatient Discharge.
- § 51483. Provider Requirements.
- § 51483.1. Personal Care Provider Requirements.
- § 51484. Billing for Suspended Provider.
- § 51485. Submission of False Information.
- § 51485.1. Civil Money Penalties.
- § 51486. Medi-Cal Card Labels.
- § 51487. Examinations of Beneficiaries.
- § 51488. Pharmaceutical Postservice—Postpayment on-Site Reviews Including Clinics with Special Permits.
- § 51488.1. Pharmaceutical Recovery Standards Including Clinics with Special Permits.
- § 51488.2. Statistical Extrapolation for Medi-Cal Pharmacy Reviews. [Repealed]
- § 51488.3. Underpayment Adjustments to Medi-Cal Reviews of Pharmacies and Clinics with Special Permits.
- § 51488.4. Adjustments to Medi-Cal Pharmacy and Clinic with a Special Permit Reviews for Unsubmitted Claims.
- § 51489. Eligibility for Payment for Paramedic Ambulance Services. [Repealed]
- § 51490. Claim Submission Requirements for Short-Doyle Medi-Cal Providers.
- § 51490.1. Claim Submission Requirements for Counties and Providers of Drug Medi-Cal Substance Use Disorder Services.
- § 51491. Local Educational Agency (LEA) Eligibility for Payment.
- § 51492. Claim Submission Requirements for Targeted Case Management Providers.
- § 51492.1. Host County Contractual Responsibilities in the Targeted Case Management Program. [Repealed]
- § 51492.2. Participation Fee Requirements in the Targeted Case Management Program.