Title WIC, California Welf. & Inst. Code

(a) A provision of a Budget Act or other statute shall not be interpreted or applied to limit the amount of federal financial participation, otherwise available under federal law, which may be reimbursable to counties in support of Medi-Cal administration costs for eligibility de…

(a) Each county shall work, on a routine basis, any error alert from the department’s Medi-Cal Eligibility Data System (MEDS). Any alert that affects eligibility or the spend down of excess income that is received by the 10th working day of the month shall be processed in time fo…

There is hereby established a Health Care Deposit Fund from which expenditures of state, county and federal funds for health care and administration under this chapter and Chapter 8 (commencing with Section 14200) shall be made upon order of the Controller in accordance with cert…

Notwithstanding any other provision of law, any federal and county funds, excluding county funds used for the purposes of Section 4011.1 of the Penal Code, received under the provisions of Section 14157 during each fiscal year, as reimbursement for expenditures for health care se…

Funds for the medical assistance program shall be provided annually by appropriation in the Budget Act. The amount of state funds appropriated shall be transferred in such sums as are needed by the Controller from the General Fund to the Health Care Deposit Fund. (Amended by Stat…

Effective for expenditures incurred after enactment of any new demonstration project under Article 5.4 (commencing with Section 14180), any federal financial participation that is available under the federal Medicaid Program, or any related waiver or demonstration project, based …

Funds appropriated for purposes of this chapter and Chapter 8 (commencing with Section 14200), shall fully cover and shall not exceed the state’s share of payments under this chapter and Chapter 8 (commencing with Section 14200), for the costs of medical care and services, county…

Commencing with the 2004–05 fiscal year, expenditures for Medi-Cal services and fiscal intermediary and county administration costs included in the department’s budget shall be charged against the appropriation for the fiscal year in which the billing is paid. Commencing July 1, …

The provisions of Chapter 577 of the Statutes of 1971 in no way eliminate fiscal obligation incurred prior to July 1, 1971, by any county or the state under Article 5 (commencing with Section 14150) of Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code. After …

Whenever an amount is or was prior to the effective date of this section, erroneously deposited in the Health Care Deposit Fund, including, but not limited to, duplicate payments and payments in excess of the correct amount, the erroneous amount shall be refunded to the depositor…

Carriers and providers of Medi-Cal benefits shall be required to utilize uniform accounting and cost-reporting systems as shall be developed and adopted by the department. If any other provision of law provides for uniform accounting and cost-reporting systems for hospitals, the …

(a) Beginning in 1991, the State Department of Health Services shall include in the November estimate of Medi-Cal expenditures and the Governor’s Budget an estimate of savings from the prior year which resulted from implementation of Senate Bill 2174 of the 1987–88 Regular Sessio…

(a) For purposes of this section, the following definitions shall apply: (1) “Public entity” means a county, a city, a city and county, the State of California, the University of California, a local health care district, a local health authority, or any other political subdivisio…

(a) In addition to the required intergovernmental transfers set forth in Section 14163, any county, other political subdivision of the state, or governmental entity in the state may elect to transfer funds, subject to subdivision (m) of Section 14163, to the department in support…

For the purposes of this article: (a) “Access” means the right to inspect, review, and obtain an accurate copy of any record obtained in the course of providing services under this division. A regional center or state-operated facility may make a reasonable charge in an amount no…

Notwithstanding any other law, access to records regarding an applicant for, or recipient of, services shall be provided, upon request, to the applicant, recipient, or their authorized representative, including the person appointed as a developmental services decisionmaker pursua…

Nothing in this chapter shall be construed to compel a physician, psychologist, social worker, nurse, attorney, or other professional person to reveal information which has been given to him or her in confidence by members of a recipient’s or applicant’s family. (Added by Stats. …

Each regional center and the department for its state-operated facilities shall adopt procedures for granting of requests by persons authorized under Section 4726 for access to records during regular business hours, provided that access shall be granted no later than three busine…

Whenever access to regional center or state-operated facility records is requested, the regional center or state-operated facility shall provide at least the following information: (a) The types of records maintained by the service agency. (b) The position of the official respons…

Any person who willfully and knowingly violates the provisions of this article is guilty of a misdemeanor. (Added by Stats. 1982, Ch. 506, Sec. 2.)

(a) Each consumer or any representative acting on behalf of any consumer or consumers, who believes that any right to which a consumer is entitled has been abused, punitively withheld, or improperly or unreasonably denied by a regional center, state-operated facility, or service …

Notwithstanding any other provision of law, no payment for care or services shall be made under Medi-Cal to the attending physician under this chapter for the costs of any voluntary nonemergency sterilization unless the treatment authorization request is accompanied by the docume…

Willful failure on the part of a health facility to comply with the provisions of the regulations of the department under this article shall constitute cause for suspension as a provider of services under Medi-Cal. (Added by Stats. 1975, Ch. 220.)

The department shall transmit any data acquired by it regarding willful failure of a physician and surgeon to comply with the regulations of the department under this article to the Medical Board of California. (Amended by Stats. 1989, Ch. 886, Sec. 107.)

The department shall submit reports to the Legislature as to compliance by health facilities with the requirements of this article, 6, 12, and 24 months after its operative date. (Added by Stats. 1975, Ch. 220.)

The Legislature finds and declares all of the following: (a) Qualified clinics, as defined in this article, are fundamental to the California health care safety net, as their mission is to provide primary and preventive care to low-income and underserved populations. (b) Stabilit…

For purposes of this article, the following definitions apply: (a) “Date of record” means a date determined by the department on which eligible employees are deemed to qualify for a retention payment, which shall be no later than 90 calendar days after the effective date of the a…

(a) Upon appropriation by the Legislature of funds for this purpose, the department shall establish a clinic workforce stabilization retention payment program to provide funds to eligible qualified clinics to make retention payments to their eligible employees for the public purp…

(a) (1) Except as required by federal law, any payment made pursuant to this article shall be exempt from any adjustments or deductions made to Medi-Cal payments to qualified clinics, including, but not limited to, provider withholds or provider payment reductions. (2) Payments m…

(a) In the event of a dispute as to the status of an employee as an eligible employee, the retention payment amount, or a qualified clinic’s failure to make a retention payment, an eligible employee or a labor organization that represents the employee may write to the qualified c…

(a) In serving as a conduit for payments under this article, qualified clinics are carrying out a state program. This article does not create a private right of action in any civil litigation against qualified clinics regarding the administration of the retention payment program …

The provisions of this article are severable. If any provision of this article or its application is held invalid, that invalidity shall not affect other provisions or applications that can be given effect without the invalid provision or application. (Added by Stats. 2022, Ch. 7…

In order to ensure the proper and efficient administration of the Medi-Cal program, every applicant, as defined in subdivision (b) of Section 14043.1, and every provider, as defined in subdivision (o) of Section 14043.1, shall be subject to the requirements of this article. (Amen…

As used in this article: (a) “Abuse” means either of the following: (1) Practices that are inconsistent with sound fiscal or business practices and result in unnecessary cost to the federal Medicaid and Medicare programs, the Medi-Cal program, another state’s Medicaid program, or…

(a) The department may adopt regulations for certification of each applicant and each provider in the Medi-Cal program. No certification shall be required for natural persons licensed or certificated under Division 2 (commencing with Section 500) of the Business and Professions C…

(a) Notwithstanding any other law, within 30 calendar days of receiving confirmation of certification for enrollment as a Medi-Cal provider for an affiliate primary care clinic that is licensed pursuant to Section 1218.1 of the Health and Safety Code, the department shall provide…

(a) Whether or not regulations for certification are adopted under Section 14043.15, in order to be enrolled as a provider, or for enrollment as a provider to continue, an applicant or provider may be required to sign a provider agreement and shall disclose all information as req…

(a) The application form for enrollment, the provider agreement, and all attachments or changes to either, shall be signed under penalty of perjury. (b) The department may require that the application form for enrollment, the provider agreement, and all attachments or changes to …

(a) (1) On and after January 1, 2004, an applicant that currently is not enrolled in the Medi-Cal program, or a provider applying for continued enrollment, upon written notification from the department that enrollment for continued participation of all providers in a specific pro…

(a) If an applicant or provider is granted provisional provider status, preferred provisional provider status, or full-enrollment status pursuant to Section 14043.26 and, if at any time during the provisional provider status period, preferred provisional provider status period, o…

(a) (1) If an application package is denied under Section 14043.26 or provisional provider status, preferred provisional provider status, or full-enrollment status is terminated under Section 14043.27, the applicant or provider shall be prohibited from reapplying for enrollment o…

(a) If, at the end of the period for which provisional provider status or preferred provisional provider status was granted under Section 14043.26, all of the following conditions are met, the provisional status shall cease and the provider shall be enrolled in the Medi-Cal progr…

A provider shall be required to reimburse those Medi-Cal funds received during any period for which material information was not reported, or reported falsely, to the department. (Added by Stats. 1999, Ch. 146, Sec. 37. Effective July 22, 1999.)

(a) As a condition of a pharmacy’s participation in the Medi-Cal program, the pharmacy shall have in stock and regularly dispense prescription drugs. (b) For purposes of this section, “prescription drugs” means any drug unsafe for self use by a person, and includes either of the …

(a) Each provider that dispenses, as defined in Section 4024 of the Business and Professions Code, or that furnishes, as defined in Section 4026 of the Business and Professions Code, a controlled drug, a dangerous drug, or a dangerous device to a Medi-Cal beneficiary, or a drug o…

Sections 14043.2, 14043.25, and 14043.3 shall not limit the authority granted the director and the rights granted providers in Section 14123. Action taken under the authority granted in Section 14123 shall be taken in accordance with that section. (Added by Stats. 1999, Ch. 146, …