ARTICLE 1. General Provisions

Article 1 added by Stats. 1965, 2nd Ex. Sess., Ch. 4.

§§ 14000–14042.2 · 233 sections

§ 14000 The purpose of this chapter is to afford to qualifying individuals health care and related remedial or preventive services, including related social services…
§ 14000.01 The department shall seek federal approval, if necessary, and shall issue all-plan letters or similar instructions to implement subdivision (d) of Section…
§ 14000.03 (a) The Legislature finds and declares that Section 1396a(a)(11)(A) of Title 42 of the United States Code provides that California’s state plan for medical…
§ 14000.05 The State Department of Health Services shall consider the special needs and requirements of rural hospitals in California that are financially distressed and…
§ 14000.1 It is the intent of the Legislature that health care services available under this chapter shall be at least equivalent to the level provided in 1970–71.
§ 14000.2 During the time this chapter is effective and notwithstanding other provisions of the Welfare and Institutions Code and Health and Safety Code, the board of…
§ 14000.3 To the extent permitted by federal law, the director may enter into contracts with the Secretary of Health, Education, and Welfare to obtain or provide fiscal…
§ 14000.4 This chapter shall be known and may be cited as the “Medi-Cal Act.”
§ 14000.5 On a regional pilot project basis, to the extent authorized by law, the director may enter into contracts with one or more nonprofit organizations to perform…
§ 14000.6 (a) The Office of Medicare Innovation and Integration is hereby established within the department. (b) The office shall do all of the following: (1) Provide…
§ 14000.7 (a) The department shall provide assistance to any applicant or beneficiary that requests help with the application or redetermination process to the extent…
§ 14000.8 (a) (1) Commencing on January 1, 2026, and each month thereafter, a county with a call center for Medi-Cal applicants or beneficiaries applying for, renewing,…
§ 14001 Health care as administered under this chapter shall be considered a component of public social services.
§ 14001.1 It is the intention of the Legislature, whenever feasible, that the needs of categorically needy persons for health care and related remedial or preventive…
§ 14001.11 (a) The department shall implement the federal requirements described in Section 1396u-5 of Title 42 of the United States Code. (b) In each of the several…
§ 14002 Health care granted under the provisions of this chapter is held subject to the provisions of any law hereafter enacted amending, repealing, or supplementing…
§ 14002.5 For the purposes of this article, the following definitions shall apply: (a) “Annuity” means a contract that names an annuitant and gives a person or entity…
§ 14003 The Governor may enter into and execute in behalf of the state all necessary agreements in connection with this chapter as may be required by the United States…
§ 14004 If any individual in good faith adheres to the teachings of any bona fide church, sect, denomination, or organization, and in accordance with its principles…
§ 14005 (a) The health care benefits and services specified in this chapter, to the extent that such services are neither provided under any other federal or state law…
§ 14005.1 Except for adults receiving aid pursuant to Chapter 2 (commencing with Section 11200) and for whom federal financial participation would not be obtainable for…
§ 14005.2 Unless otherwise specified in this chapter, the eligibility of a person eligible under the Cuban-Haitian Entrant Program or the Refugee Resettlement Program…
§ 14005.3 (a) Notwithstanding any other provision of this chapter, any person who: (1) Was once determined to be disabled in accordance with Section 1614 of Part A of…
§ 14005.4 Unless otherwise specified in this chapter, the eligibility of a state-only Medi-Cal person for health care services under Section 14005 shall be determined by…
§ 14005.5 (a) In determining eligibility pursuant to Section 14005.4 or 14005.7, reparation or restitution payments received by victims of the Nazi persecution from the…
§ 14005.6 (a) The Legislature finds and declares as follows: (1) Under federal law, minors living at home with their families may not be eligible for the SSI and…
§ 14005.60 (a) Commencing January 1, 2014, the department shall provide Medi-Cal benefits for individuals who meet eligibility requirements of Section…
§ 14005.61 (a) Except as provided in subdivision (e), individuals who are enrolled in a Low Income Health Program (LIHP) as of December 31, 2013, under California’s…
§ 14005.62 (a) (1) Notwithstanding any other law, for an applicant or beneficiary whose eligibility is not determined using the modified adjusted gross income…
§ 14005.63 (a) A person who wishes to apply for an insurance affordability program shall be allowed to file an application on his or her own behalf or on behalf of his or…
§ 14005.64 (a) Effective January 1, 2014, and notwithstanding any other law, when determining eligibility for Medi-Cal benefits, an applicant’s or beneficiary’s income…
§ 14005.65 (a) The department shall file a state plan amendment to exercise the federal option under subdivision (h) of Section 435.603 of Title 42 of the Code of Federal…
§ 14005.66 The department shall seek any federal waivers necessary to use the eligibility information of individuals who have been determined eligible for the CalFresh…
§ 14005.67 The department shall seek any federal waivers necessary to automatically enroll parents in the Medi-Cal program who apply for Medi-Cal benefits and have one or…
§ 14005.68 The department may seek any federal waivers or state plan amendments necessary to use the eligibility information of individuals determined eligible for other…
§ 14005.69 (a) It is the intent of the Legislature that the department implement work or community engagement requirements set forth in Section 1396a(xx) of Title 42 of…
§ 14005.7 (a) Medically needy persons and medically needy family persons are entitled to health care services under Section 14005 providing all eligibility criteria…
§ 14005.70 (a) The State Department of Health Care Services shall ensure that its contracts with a health care service plan or health insurer to provide Medi-Cal managed…
§ 14005.73 A person who is otherwise eligible for Medi-Cal benefits under either Section 14005.4 or 14005.7, except for income and resource eligibility, and who is…
§ 14005.75 (a) The Legislature finds and declares all of the following: (1) As a result of federal welfare reform, unprecedented numbers of welfare recipients will be…
§ 14005.76 (a) The department shall provide a Medi-Cal beneficiary whose Medi-Cal eligibility is established pursuant to Section 1930 of the federal Social Security Act…
§ 14005.8 (a) (1) To the extent required by Subchapter XIX (commencing with Section 1396) of Chapter 7 of Title 42 of the United States Code and regulations adopted…
§ 14005.84 (a) The department shall develop and conduct a community outreach and education campaign to assist persons whose Medi-Cal eligibility is established pursuant…
§ 14005.85 (a) Families who, because of marriage or because separated spouses reunite, lose AFDC eligibility under the chapter because the family no longer meets the need…
§ 14005.88 (a) The department shall contract for an independent evaluation, to be completed no later than January 1, 2001, in order to determine the effect of changes…
§ 14005.89 (a) The department shall monitor participation rates for transitional Medi-Cal and seek input from beneficiaries, beneficiary representatives, and counties, on…
§ 14005.9 (a) The spend down amount of excess income necessary to become eligible for Medi-Cal shall be determined on a monthly basis. No person or family shall be…
§ 14005.95 (a) For persons in long-term care, any income deductions, with the exception of other health insurance premiums under Sections 14005.4 and 14005.7, shall not…
§ 14005.10 For purposes of facilitating arrangements for health care through prepaid health plans, the department may set standards for determining monthly income, for…
§ 14005.11 (a) To the extent required by federal law for qualified beneficiaries enrolled in the federal Medicare Program, the department shall pay the premiums,…
§ 14005.12 (a) For the purposes of Sections 14005.4 and 14005.7, the department shall establish the income levels for maintenance need at the lowest levels that… see note
§ 14005.13 (a) Notwithstanding Section 14005.12, when an individual residing in a long-term care facility would incur a long-term care patient liability for services… see note
§ 14005.14 (a) In addition to the income exemptions specified in subdivision (a) of Section 14005.7, an income exemption shall be allowed each month for the amount…
§ 14005.15 Notwithstanding the provisions of Section 14005, Medi-Cal beneficiaries shall obtain family planning services through the Medi-Cal program to the extent they…
§ 14005.16 (a) In determining the eligibility of a married individual pursuant to Section 14005.4 or 14005.7, who resides in a nursing facility, and who is in a Medi-Cal…
§ 14005.17 (a) In determining the eligibility of an institutionalized spouse pursuant to Section 14005.4 or 14005.7, who resides in a medical institution or nursing…
§ 14005.18 (a) (1) An individual is eligible, to the extent required by federal law, as though the individual was pregnant, for all pregnancy-related and postpartum…
§ 14005.185 (a) Notwithstanding Section 15840, the income eligibility requirements specified in Section 15832, and the annual redetermination requirements described in…
§ 14005.19 The receipt of respite care, as defined in Section 1418.1 of the Health and Safety Code, shall not affect the eligibility of any individual with respect to…
§ 14005.20 (a) The department shall adopt the option made available under Section 1902(a)(10)(A)(ii)(XII) of Title XIX of the federal Social Security Act (42 U.S.C. Sec.…
§ 14005.21 (a) Any medically needy aged, blind, or disabled person who was categorically needy under this chapter on the basis of eligibility under Chapter 3 (commencing…
§ 14005.22 (a) A pregnant individual is eligible for full-scope Medi-Cal benefits under Section 435.116(d)(2) of Title 42 of the Code of Federal Regulations if their…
§ 14005.23 To the extent federal financial participation is available, the department shall, when determining eligibility for children under Section 1396a(l)(1)(D) of…
§ 14005.24 The department shall instruct counties, by means of an all county letter or similar instruction, as to the process that is to be used to ensure that each…
§ 14005.25 (a) To the extent federal financial participation is available, the department shall exercise the option under Section 1902(e)(12) of the federal Social…
§ 14005.255 (a) (1) Notwithstanding Section 14005.25, subject to paragraph (2) and subdivision (d), a child shall be continuously eligible for Medi-Cal up to, five years…
§ 14005.26 (a) (1) Except as provided in subdivision (b), the department shall exercise the option pursuant to Section 1902(a)(l0)(A)(ii)(XIV) of the federal Social…
§ 14005.27 (a) Individuals enrolled in the Healthy Families Program pursuant to Part 6.2 (commencing with Section 12693) of Division 2 of the Insurance Code on June 27,…
§ 14005.271 (a) The Healthy Families Advisory Board established by former Section 12693.90 of the Insurance Code is hereby renamed the Medi-Cal Children’s Health Advisory…
§ 14005.275 The department shall ensure coordination of covered services across all delivery systems of care in order to minimize disruption in services for children…
§ 14005.277 In order to assist the California Health Benefit Exchange, established pursuant to Title 22 (commencing with Section 100500) of the Government Code, to conduct…
§ 14005.28 (a) To the extent federal financial participation is available pursuant to an approved state plan amendment, the department shall implement Section…
§ 14005.285 (a) To the extent federal financial participation is available pursuant to an approved state plan amendment, the department shall exercise its option under…
§ 14005.287 (a) To the extent federal financial participation is available pursuant to an approved state plan amendment, the department shall exercise its option under…
§ 14005.288 (a) To the extent federal financial participation is available pursuant to an approved state plan amendment, the department shall exercise its option under…
§ 14005.29 To the extent that federal matching funds are available, disabled persons who are otherwise eligible for benefits under this chapter, except for income due to…
§ 14005.30 (a) Medi-Cal benefits under this chapter shall be provided to individuals eligible for services under Section 1396u-1 of Title 42 of the United States Code…
§ 14005.31 (a) (1) Subject to paragraph (2), for any person whose eligibility for benefits under Section 14005.30 has been determined with a concurrent determination of…
§ 14005.32 (a) (1) If the county has evidence clearly demonstrating that a beneficiary is not eligible for benefits under this chapter pursuant to Section 14005.30, but…
§ 14005.33 (a) If a Medi-Cal beneficiary’s Medi-Cal eligibility worker is changed, notice shall be sent to the beneficiary within 10 days of the change. This notice shall…
§ 14005.34 (a) For an individual whose cash aid was terminated pursuant to Chapter 2 (commencing with Section 11200), but whose Medi-Cal eligibility was continued either…
§ 14005.35 The department, in consultation with the counties and representatives of consumers, managed care plans, and Medi-Cal providers, shall study the feasibility of…
§ 14005.36 (a) (1) (A) The department shall undertake efforts to conduct outreach about work or community engagement requirements, more frequent redeterminations, and…
§ 14005.365 (a) It is the intent of the Legislature to develop a data dashboard to collect, track, analyze, and report on metrics related to the impact of federal H.R. 1…
§ 14005.37 (a) (1) Except as provided in paragraph (2) or as provided in Section 14005.39, a county shall perform redeterminations of eligibility for Medi-Cal…
§ 14005.38 (a) The principal and interest of a 529 savings plan shall be excluded from consideration for purposes of any asset or resources test to determine eligibility…
§ 14005.39 (a) If a county has facts clearly demonstrating that a Medi-Cal beneficiary cannot be eligible for Medi-Cal due to an event, such as death or change of state…
§ 14005.40 (a) To the extent federal financial participation is available, the department shall exercise its option under Section 1902(a)(10)(A)(ii)(X) of the federal…
§ 14005.401 (a) The department shall seek a Medicaid state plan amendment or waiver to implement an income disregard that would allow an aged, blind, or disabled…
§ 14005.41 (a) Notwithstanding any other law, the department shall deem to have met the income documentation requirements for participation in the Medi-Cal program,…
§ 14005.42 (a) The department shall provide full-scope benefits under this chapter, without spend down of excess income, to all individuals on behalf of whom kinship…
§ 14005.50 (a) To the extent that federal financial participation is available, the department shall exercise the option made available under Section…
§ 14006 (a) This section applies to medically needy persons, medically needy family persons, and state-only Medi-Cal persons. (b) For the purposes of this section, the…
§ 14006.01 (a) This section applies to any individual who is residing in a continuing care retirement community, as defined in paragraph (10) of subdivision (c) of…
§ 14006.15 (a) For the purposes of this section, “equity interest” means the lesser of the following: (1) The assessed value of the principal residence determined under…
§ 14006.2 (a) In determining the eligibility of a married individual, pursuant to Section 14005.4 or 14005.7, who, in accordance with Title XIX of the federal Social…
§ 14006.3 (a) The department, at the time of application or the assessment pursuant to Section 14006.6, and any nursing facility enrolled as a provider in the Medi-Cal…
§ 14006.4 (a) The statement required by Sections 14006.2 and 14006.3 shall be in the following form: “NOTICE REGARDING STANDARDS FOR MEDI-CAL ELIGIBILITY If you or your…
§ 14006.41 (a) To be eligible for medical assistance for home and facility care, an individual shall disclose at the time of the individual’s application or…
§ 14006.5 (a) The department shall include training regarding the treatment of separate and community income and resources in determining eligibility for Medi-Cal… see note
§ 14006.6 (a) To the extent required by Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396 et seq.) and regulations adopted pursuant thereto, upon the…
§ 14006.7 (a) At the time of application for Medi-Cal benefits, the department shall provide to any applicant who is aged, blind, or disabled, other than an individual…
§ 14007 No period of residence in this state shall be required as a condition of eligibility under this chapter, but an individual who does not reside in this state…
§ 14007.1 (a) The department shall electronically verify an individual’s state residency using information from the federal Supplemental Nutrition Assistance Program,…
§ 14007.12 (a) No later than January 1, 2027, the department shall establish a process to regularly obtain address information for individuals enrolled in the Medi-Cal…
§ 14007.15 (a) Except as provided in subdivision (f), an individual is a resident of this state if he or she is 21 years of age or older, is not residing in an…
§ 14007.2 (a) Any individual who is otherwise eligible for Medi-Cal services, but who does not meet the documentation requirements described in subdivision (e) of…
§ 14007.4 Any children under the jurisdiction of the county welfare department, who are dependent children in relative placement, foster home placement, or group home…
§ 14007.45 (a) To the extent federal financial participation is available, the department shall exercise the option provided in Section 1920A of the federal Social…
§ 14007.5 (a) Persons who are not citizens or nationals of the United States shall be eligible for Medi-Cal, whether federally funded or state-funded, only to the same…
§ 14007.6 (a) A recipient who maintains a residence outside of this state for a period of at least two months shall not be eligible for services under this chapter where…
§ 14007.65 (a) Persons who are not citizens or nationals of the United States who were receiving long-term care services under the authority of subdivision (f) of Section…
§ 14007.7 Any person who is not a citizen or national of the United States who is otherwise eligible for Medi-Cal services, but who does not meet the requirements under…
§ 14007.705 (a) Through its courts and statutes, and under its Constitution, California protects a woman’s right to reproductive privacy. California reaffirms these…
§ 14007.71 (a) The department shall adopt the option made available under Section 1396a(a)(10)(A)(ii)(XVIII) of Title 42 of the United States Code, to provide medical…
§ 14007.8 (a) (1) An individual who is 25 years of age or younger, and who does not have satisfactory immigration status or is unable to establish satisfactory…
§ 14007.9 (a) (1) The department shall adopt the option made available under Section 1902(a)(10)(A)(ii)(XIII) of the federal Social Security Act (42 U.S.C. Sec.…
§ 14008 (a) No relative, other than the spouse, shall be held to be financially responsible for the cost of health care received by an adult eligible under this…
§ 14008.6 (a) As a condition of eligibility for medical services provided under this chapter or Chapter 8 (commencing with Section 14200), each applicant or beneficiary…
§ 14008.7 If the applicant or beneficiary does not cooperate in the manner described in subdivisions (b) and (c) of Section 14008.6 to establish paternity and medical…
§ 14009 (a) Any applicant for, or beneficiary of Medi-Cal, or person acting on behalf of an applicant or beneficiary shall be informed as to the provisions of…
§ 14009.5 (a) It is the intent of the Legislature, with the amendments made to this section by the act that added subdivision (g), to do all of the following: (1) Limit…
§ 14009.6 (a) As a result of providing medical assistance for home and facility care to an individual, the state shall, by operation of law, become a remainder…
§ 14009.7 (a) If an annuity is considered part or all of the community spouse resource allowance allowed under subdivision (c) of Section 14006, the state shall only…
§ 14010 (a) Notwithstanding any other provision of law, the parent or parents of a person under 21 years of age shall not be held financially responsible, nor shall…
§ 14011 (a) An applicant who is not a recipient of aid under Chapter 2 (commencing with Section 11200) or Chapter 3 (commencing with Section 12000) shall be required…
§ 14011.1 (a) The department shall, not later than July 1, 1998, create and implement a simplified application package for the following Medi-Cal applicants, as…
§ 14011.10 (a) Except as provided in Sections 14053.7, 14053.8, and 14184.800, benefits provided under this chapter to an individual who is an inmate of a public…
§ 14011.15 (a) The department shall, not later than July 1, 2000, create and implement a simplified application package for children, families, and adults applying for…
§ 14011.2 (a) The department shall require that each applicant for or beneficiary of Medi-Cal, including a child, who is not a recipient of aid under the provisions of…
§ 14011.25 To the extent federal financial participation is available, the department shall take all steps necessary to comply with the terms and conditions of the State…
§ 14011.3 (a) To the same extent as required by federal law, a person who is not a citizen or national of the United States whose entry into the United States has been…
§ 14011.4 The department shall, subject to the requirements of federal law, and not later than six months after the effective date of this section, develop a simple…
§ 14011.5 The department shall be responsible for establishing the necessary systems for the identification, review and approval, disbursement, and reimbursement systems…
§ 14011.6 (a) To the extent federal financial participation is available, the department shall exercise the option provided in Section 1920a of the federal Social…
§ 14011.65 (a) To the extent allowed under federal law and only if federal financial participation is available under Title XXI of the Social Security Act (42 U.S.C. Sec.…
§ 14011.65a (a) To the extent allowed under federal law under Title XIX (42) U.S.C. 1396 et seq.) and Title XXI (42 U.S.C. 1397aa et seq.) of the Social Security Act, and…
§ 14011.65b (a) To the extent federal financial participation is available, the department shall exercise the option provided in Section 1920a of the federal Social…
§ 14011.66 (a) Effective January 1, 2014, the department shall provide Medi-Cal benefits during a presumptive eligibility period to individuals who have been determined…
§ 14011.7 (a) To the extent allowed under federal law and only if federal financial participation is available, the department shall exercise the option provided in…
§ 14011.75 (a) The department shall conduct, or contract for the conducting of, a feasibility study report of technological requirements for modifying the electronic…
§ 14011.78 (a) The department may contract with public or private entities, or utilize existing health care service provider payment mechanisms, including the Medi-Cal…
§ 14011.8 (a) Benefits provided to an individual pursuant to a preliminary determination as described in Section 1396r-1, 1396r-1a, or 1396r-1b of Title 42 of the United…
§ 14011.9 (a) On or before October 1, 2002, the department shall issue instructions to counties via an all-county letter or similar instructions to establish an…
§ 14012 (a) The Legislature finds and declares that the goal of the Medi-Cal program is to provide comprehensive health care to low-income Californians who cannot…
§ 14012.5 (a) By July 1, 2007, the department shall implement a process that allows applicants and beneficiaries to self-certify the amount and nature of assets and…
§ 14013 The department shall establish a system for investigation of a sufficient sample of applications and affirmations as shall be deemed necessary to assure the…
§ 14013.3 (a) When determining whether an individual is eligible for Medi-Cal benefits, the department shall verify the accuracy of the information identified in this…
§ 14013.5 (a) Pursuant to, and only to the extent required by, Section 1940 of the federal Social Security Act (42 U.S.C. Sec. 1396w) and subject to the provisions of…
§ 14014 (a) Any person receiving health care for which he or she was not eligible on the basis of false declarations as to his or her eligibility or any person making…
§ 14014.5 (a) It is the intent of the Legislature to protect individual privacy and the integrity of Medi-Cal and other insurance affordability programs by restricting…
§ 14015 (a) (1) The providing of health care under this chapter shall not impose any limitation or restriction upon the person’s right to sell, exchange or change the…
§ 14015.1 (a) The department shall consider, at initial application or redetermination, whether an undue hardship, as described in subdivision (b), exists prior to…
§ 14015.12 (a) For the purposes of this section, the following definitions shall apply: (1) “Opposite-sex spouse” means a person of the opposite sex who is legally…
§ 14015.2 (a) In accordance with Section 1917(c)(2)(D) of the federal Social Security Act (42 U.S.C. Sec. 1396p(c)(2)(D)), any of the following may request a fair…
§ 14015.5 (a) Notwithstanding any other state law, the department shall retain or delegate the authority to perform Medi-Cal eligibility determinations as set forth in…
§ 14015.7 (a) (1) Notwithstanding any other provision of law, for persons who call the customer service center operated by the Exchange for the purpose of applying for…
§ 14015.8 (a) The department, any other government agency that is determining eligibility for, or enrollment in, the Medi-Cal program or any other program administered…
§ 14016 (a) The county in which the person resides, except as specified in subdivision (d), shall determine the eligibility of each person pursuant to Sections…
§ 14016.1 If a patient at a health facility operated by the county either directly or through contract is received in a comatose condition or suffering from amnesia and…
§ 14016.2 (a) If a person who is incapable of acting on their own behalf and who would otherwise be eligible is discontinued from Medi-Cal eligibility because the…
§ 14016.3 The department shall provide technical assistance to counties in order to maximize the identification of private health care coverage as defined by Section…
§ 14016.4 The department may enter into an agreement with a county to have the county detect and recover the value of any Medi-Cal benefits which have been improperly…
§ 14016.5 (a) At the time of determining or redetermining the eligibility of a Medi-Cal program or Aid to Families with Dependent Children (AFDC) program applicant or…
§ 14016.51 Upon the availability of federal funding, the department shall modify the Medi-Cal program mail-in application form, and other appropriate materials, and the…
§ 14016.55 (a) It is the intent of the Legislature that Medi-Cal beneficiaries who are required to enroll in a Medi-Cal managed care health plan make an informed choice…
§ 14016.6 The State Department of Health Care Services shall develop a program to implement subdivision (p) of Section 14016.5 and to provide information and assistance…
§ 14016.7 (a) Managed care contracts entered into by the department under the act adding this section shall include all of the following: (1) Contractor requirements…
§ 14016.8 (a) The Legislature finds and declares that the right of every patient to receive basic information necessary to give full and informed consent is a…
§ 14016.9 Where determined to be cost effective, the department shall utilize the earnings clearance system to verify the eligibility of persons who have applied for or…
§ 14016.10 The department shall implement the federal requirement under Section 4603 of the Omnibus Budget Reconciliation Act of 1990 (P.L. 101–508) which provides for…
§ 14017 On a regional pilot project basis, the department may issue an identification card to a person eligible for Medi-Cal program benefits under Section 14005.1,…
§ 14017.1 The Joint Legislative Audit Committee shall conduct an audit of one or more county eligibility departments.
§ 14017.5 The department shall not issue identification cards to Medi-Cal recipients on a statewide basis until (1) a pilot project has been completed which indicates…
§ 14017.6 For the purposes of this chapter, all references to “the Medi-Cal card,” identified in Section 14017.8, shall be deemed to also be a reference to the benefits…
§ 14017.7 (a) In addition to the issuance of Medi-Cal cards, pursuant to Section 14017.8, the department may issue a benefits identification card for the purpose of…
§ 14017.8 Each person eligible under Section 14005.1 and each person eligible under Section 14005.4 or 14005.7 who is certified eligible shall be provided, by the…
§ 14018 (a) (1) The Medi-Cal card shall be authorization for payment for health care services rendered, during and subsequent to the month of application of a person…
§ 14018.1 The department shall prospectively notify a Medi-Cal managed care plan of the date of the regularly scheduled annual redetermination of a Medi-Cal beneficiary…
§ 14018.2 (a) Reimbursement shall not be denied to any qualified health care provider for care rendered to an eligible Medi-Cal beneficiary for the sole reason that a…
§ 14018.4 (a) Reimbursement shall not be denied to any hospital, licensed primary care clinic, or long-term health care facility as defined in Section 1326 of the Health…
§ 14018.5 Notwithstanding any other provision of law, Section 3275 of the Civil Code does not apply to Medi-Cal reimbursement or prior authorization.
§ 14018.7 (a) Notwithstanding any other provision of law, neither a member of the governing body of the commission nor a member of any advisory panel to the governing…
§ 14019 (a) (1) Notwithstanding Section 14018, except as provided in Section 14019.6, Medi-Cal eligibility shall be authorization for payment for health care services…
§ 14019.3 (a) A beneficiary or any person on behalf of a beneficiary who has paid for medically necessary health care services, otherwise covered by the Medi-Cal…
§ 14019.4 (a) A provider of health care services who obtains a label or copy from the Medi-Cal card or other proof of eligibility pursuant to this chapter shall not seek…
§ 14019.5 Nothing in this chapter shall be construed as imposing any control over the management of any medical or health care facility, except that each such facility…
§ 14019.6 Notwithstanding any other provision of law, no person, whose property reserve exceeds the property limit, may establish eligibility for the applicable…
§ 14019.7 (a) Notwithstanding Section 14019.4 and if permitted by federal law, a relative of a skilled nursing facility resident who is a beneficiary under this chapter…
§ 14020 All sections of this chapter shall remain in operation during such times as grants-in-aid are provided or made available to the state on the basis of a state…
§ 14021 Notwithstanding any other provision of this chapter, health care shall include the following mental health and substance use disorder services: (a) Mental…
§ 14021.2 (a) The department shall develop a proposal for the United States Secretary of Health and Human Services for selection as a participating state in the…
§ 14021.3 The state plan for medical assistance under Medicaid pursuant to Section 1915(g) of Title 19 of the federal Social Security Act, as amended by Public Law…
§ 14021.30 (a) It is the intent of the Legislature to transfer to the State Department of Health Care Services, no later than July 1, 2012, the administration of the Drug…
§ 14021.31 The department, in collaboration with the State Department of Alcohol and Drug Programs, shall develop an administrative and programmatic transition plan to…
§ 14021.33 A regulation or order concerning the Drug Medi-Cal Treatment Program adopted by the State Department of Alcohol and Drug Programs pursuant to former Chapter…
§ 14021.35 (a) The department shall prepare and submit amendments to the Medicaid state plan and apply for any necessary waivers in order to obtain federal financial…
§ 14021.4 (a) California’s plan for federal Medi-Cal grants for medical assistance programs, pursuant to Subchapter XIX (commencing with Section 1396) of Title 42 of the…
§ 14021.5 (a) Notwithstanding any other provision of law, rates for reimbursing specialty mental health and substance use disorder services allowable under the Medi-Cal…
§ 14021.51 (a) For purposes of this section, “narcotic treatment program services” includes, but is not limited to, all of the following: (1) Admission, physical…
§ 14021.52 (a) (1) The Legislature finds and declares all of the following: (A) Medical treatment for indigent patients who are not eligible for Medi-Cal is essential to…
§ 14021.53 A narcotic treatment program provider may use the following instructions and financial evaluation form to comply with the requirements of paragraph (4) of…
§ 14021.6 (a) For the fiscal years prior to the 2004–05 fiscal year, and subject to the requirements of federal law, the maximum allowable rates for the Drug Medi-Cal…
§ 14021.7 (a) The department shall amend the state plan for medical assistance under the Medicaid program pursuant to subdivision (g) of Section 1396n of Title 42 of the…
§ 14021.8 The department may not utilize any information regarding whether a beneficiary’s psychiatric inpatient admission was made on a voluntary or involuntary basis…
§ 14021.9 (a) Notwithstanding any other law, for the 2009–10 fiscal year, a 10-percent reduction shall be applied to rates for Drug Medi-Cal services developed by the…
§ 14022 (a) This section shall be known as the “Medi-Cal Conflict of Interest Law.” It is the intent of the Legislature that provisions be made for disclosure of the…
§ 14022.1 Any nursing facility or any category of intermediate care facility for the developmentally disabled participating in the Medi-Cal program shall supply to the…
§ 14022.3 Long-term health care facilities shall reveal to applicants for admission, or their designated representatives, orally and in writing and prior to admission,…
§ 14022.4 (a) Any nursing facility or any category of intermediate care facility for the developmentally disabled currently certified to participate in the Medi-Cal…
§ 14022.5 (a) It is the intent of the Legislature to recognize the challenges and unique dental treatment needs of the developmentally disabled population that cannot be…
§ 14023 (a) Any applicant for coverage under this chapter who at the time of application has any other contractual or legal entitlement to any health care service…
§ 14023.7 Any provider of service seeking payment for health care services for a person eligible for these services under this chapter shall first seek to obtain payment…
§ 14024 When health care services are provided to a person under this chapter who at the time the service is provided has any other contractual or legal entitlement to…
§ 14025 (a) Any person who buys or sells a Medi-Cal card, Medi-Cal label, or Medi-Cal beneficiary identification number is guilty of a public offense punishable by…
§ 14026 (a) It is a misdemeanor for a Medi-Cal beneficiary to furnish, give, or lend his Medi-Cal card or labels to any person other than a provider of service as…
§ 14026.5 (a) The State Director of Health Services may issue Medi-Cal cards to Medi-Cal fraud investigators for the purpose of conducting investigations of Medi-Cal…
§ 14027 (a) The department may designate participating county health service agencies as health care service providers of home nursing services, subject to appropriate…
§ 14028 (a) (1) In order to ensure appropriate oversight of psychotropic medications prescribed for children, pursuant to Section 2245 of the Business and Professions…
§ 14029 Whenever a request for services authorized pursuant to subdivision (s), (t), or (v) of Section 14132 is made to the department for a child who is being…
§ 14029.5 (a) (1) Commencing January 1, 2008, immediately following the issuance of an order of the juvenile court, pertaining to the disposition of a ward of the…
§ 14029.8 Section 124260 of the Health and Safety Code shall not apply to the receipt of benefits under the Medi-Cal program.
§ 14029.91 (a) The department shall require all managed care plans contracting with the department to provide Medi-Cal services to provide language assistance services to…
§ 14029.92 (a) The department shall notify Medi-Cal beneficiaries, prospective beneficiaries, and members of the public of all of the following information: (1) The…
§ 14040 (a) Each contract for fiscal intermediary services shall allow, to the extent practicable, providers to utilize electronic means for transmitting claims to the…
§ 14040.1 (a) “Billing agent” or “billing agent of the provider” means any individual, partnership, group, association, corporation, institution, or entity, and the…
§ 14040.5 (a) A provider may, by written contract, do either of the following: (1) Authorize a billing agent to submit claims, including electronic claims, on behalf of…
§ 14041 (a) The director shall develop and implement standards for the timely processing and payment of each claim type. The standards shall be sufficient to meet…
§ 14041.1 (a) Notwithstanding any other provision of law, and to the extent not otherwise conflicting with federal law, the department may hold for a period of one…
§ 14041.5 (a) The department shall develop, disseminate, and update, on a periodic basis, claims preparation and processing software programs that may be used on…
§ 14042 Each contract for fiscal intermediary services shall provide for an automated system for verifying the eligibility of Medi-Cal recipients. The automated…
§ 14042.1 (a) No earlier than January 1, 2018, the State Department of Health Care Services shall establish a Medically Tailored Meals Pilot Program to operate for a…
§ 14042.2 (a) The Legislature finds and declares the following: (1) The Medi-Cal Managed Care Ombudsman helps resolve issues between Medi-Cal managed care members and…