Article 3 - ADMINISTRATION

Section 14100 - Agents administering chapter
Section 14100.1 - Powers and duties of director
Section 14100.2 - Confidential information
Section 14100.3 - Information posted on department web site
Section 14100.5 - Program assumptions and estimates
Section 14100.51 - Fiscal information provided fiscal committees
Section 14100.52 - Supplemental fiscal information provided fiscal committees
Section 14100.6 - Information regarding changes in roster of providers
Section 14100.7 - Bond or security provided by incontinence or medical supplies providers
Section 14100.75 - Bond or security provided by applicant when applying for enrollment
Section 14100.8 - Bond by home health agency services providers
Section 14100.9 - Bond by durable medical equipment providers
Section 14100.95 - Demonstration contracts with manufacturers of medical supplies
Section 14101 - Contracts with other state agencies
Section 14101.1 - Agreement with Secretary of Health, Education and Welfare
Section 14101.5 - Information provided to Department of Social Services
Section 14101.7 - Exchange of information with Workers' Compensation Appeals Board
Section 14102 - Recognition of program as minimum essential coverage
Section 14102.5 - Reports about enrollment process for insurance affordability programs
Section 14103 - Implementation of optional expansion of benefits to adults meeting eligibility requirements
Section 14103.2 - Disqualification of provider
Section 14103.4 - Determination of which services are elective
Section 14103.5 - Noncontract hospital in closed health facility planning area
Section 14103.6 - [First of two versions] Prior authorization for providers rendering unnecessary services
Section 14103.6 - [Second of two versions] Prior authorization for providers rendering unnecessary services
Section 14103.7 - Development of procedure codes for durable medical equipment, orthotics, and prosthetics
Section 14103.75 - Practitioner determined to be prescribing or ordering medically unnecessary or excessive services
Section 14103.8 - Beneficiaries eligible for services under both California Children's Act and Medi-Cal program
Section 14104 - Agreement with Professional Standards Review Organization for review of services
Section 14104.3 - Fiscal intermediary contracts
Section 14104.35 - Exemption of fiscal intermediary contract from Public Contract Code provisions
Section 14104.36 - Contingency payments
Section 14104.5 - Review of grievance or complaint concerning processing of payments to providers
Section 14104.6 - State employee employed by fiscal intermediary contractor
Section 14104.7 - Modification of contract with Computer Sciences Corporation
Section 14104.8 - Oversight of contract awarded to Computer Sciences Corporation
Section 14104.9 - Billing forms for submission of claims for hospital services
Section 14104.93 - Distribution of provider bulletins and other provider communications
Section 14105 - Policies and regulations limiting rates of payment
Section 14105.05 - Actions regarding coding systems
Section 14105.06 - Rates in effect for certain providers through July 31, 2005
Section 14105.07 - Limitation on rate of reimbursement to facilities providing care for developmentally disabled
Section 14105.075 - Payments to intermediate care facilities for the developmentally disabled
Section 14105.076 - Rate year for nursing facilities providing level A services
Section 14105.08 - Reimbursement rates applicable to radiology services
Section 14105.09 - Applicability of payment reductions
Section 14105.1 - Adjustment of reimbursement to hospitals for inpatient services
Section 14105.11 - Settlements with acute care hospitals with psychiatric units unintentionally violating cost reimbursement policies
Section 14105.115 - Settlement with hospital in San Diego County with pediatric convalescent facility in violation of reimbursement policy
Section 14105.12 - Specification of circumstances under which requests granted for authorization for services
Section 14105.13 - Conditions for private duty nursing agencies participation in Medi-Cal program
Section 14105.15 - Determining rates of reimbursement for inpatient hospitals services
Section 14105.16 - Reimbursement rates for pharmacies providing home infusion supplies and services
Section 14105.17 - Supplemental payments to critical access hospitals
Section 14105.18 - Providers paid rates of payment identical to rates of payment for Medi-Cal program
Section 14105.181 - Reimbursement rates for office visits billed as comprehensive family planning services
Section 14105.19 - Reduction of provider payments for certain services
Section 14105.191 - Reduction of provider payments for certain services
Section 14105.192 - Adjustment of provider payments
Section 14105.193 - Reimbursement rates for freestanding pediatric subacute care units
Section 14105.194 - Reimbursement rates for freestanding pediatric subacute care units
Section 14105.195 - Retroactive implementation of reductions and limitations to reimbursement for services provided by or recoupment of overpayments from certain skilled nursing facilities
Section 14105.196 - [Repealed]
Section 14105.197 - Reimbursement rates or payments for services and providers
Section 14105.200 - The Medi-Cal Provider Payment Reserve Fund (§ 14105.200)
Section 14105.201 - Reimbursement rates
Section 14105.202 - [Repealed]
Section 14105.2 - Markup payable for dispensing medical supplies by assistive device and sickroom supply dealers
Section 14105.21 - Billing Medi-Cal for prosthetic and orthotic appliances
Section 14105.22 - Reimbursement for clinical laboratory or laboratory services
Section 14105.221 - Donations of or discounts for clinical laboratory tests or examinations or laboratory services
Section 14105.222 - Reductions and limitations to the reimbursement not retroactive
Section 14105.23 - Reimbursement for portable X-ray transportation services
Section 14105.24 - Reimbursement to Los Angeles County clinics and hospital outpatient departments participating Medicaid Demonstration Project
Section 14105.25 - Rate of reimbursement for Part B Medicaid program service or item
Section 14105.26 - Supplemental reimbursement to facilities for skilled nursing services
Section 14105.27 - Supplemental reimbursement to facilities for skilled nursing services
Section 14105.28 - Inpatient hospital reimbursement methodology based on diagnosis-related groups
Section 14105.281 - Rates for hospital inpatient services frozen
Section 14105.29 - Payments for Medi-Cal managed care share of graduate medical education costs
Section 14105.3 - Contracts to obtain manufacturers' most favorable price for drugs
Section 14105.31 - Definitions for purposes of Medi-Cal drug list
Section 14105.33 - Contracts with manufacturers of single source and multiple source drugs; list of drugs maintained
Section 14105.332 - Rebates not reduced if manufacturer reports revised drug product's average manufacturer price or best price
Section 14105.334 - Drug rebate program
Section 14105.336 - [Repealed]
Section 14105.337 - [Repealed]
Section 14105.34 - Annual report as to drug costs
Section 14105.35 - Drugs included in Medi-Cal drug formulary included on list of contract drugs
Section 14105.36 - Medi-Cal Drug Rebate Fund
Section 14105.37 - Notification to manufacturers of drugs in therapeutic categories
Section 14105.38 - Deletion of drug from list of contract drugs
Section 14105.39 - Request by manufacturer of new single source drug for inclusion of drug on list of contract drugs
Section 14105.395 - Utilization controls for drugs, medical supplies, etc.
Section 14105.4 - Medi-Cal Contract Drug Advisory Committee
Section 14105.405 - Request for hearing to dispute deletion or suspension of drug from list
Section 14105.406 - Considering suspension or deletion of drugs
Section 14105.41 - Deposit of money from contracts
Section 14105.42 - Report after first three major therapeutic categories reviewed and contracts executed
Section 14105.425 - Emergency regulatory action not precluded
Section 14105.43 - Drugs approved for treatment of AIDS or AIDS related condition
Section 14105.435 - Drug assigned reimbursement code
Section 14105.436 - State rebate provided by pharmaceutical manufacturers
Section 14105.44 - Expedited review to examine effectiveness of investigational drugs and services
Section 14105.45 - Reimbursement to pharmacy providers for legend and nonlegend drugs
Section 14105.451 - Pharmacy reimbursement based on actual acquisition costs
Section 14105.455 - Usual and customary charge submitted by pharmacy providers when billing
Section 14105.456 - Reimbursement for physician-administered drug
Section 14105.46 - 340B drugs dispensed to beneficiaries
Section 14105.467 - Supplemental payment pool for nonhospital 340B community clinics
Section 14105.468 - Directed payment program
Section 14105.47 - List of medical supplies; list of maximum allowable product costs (MAPCS) for medical supplies
Section 14105.475 - Review of and contract for various products in specific product category
Section 14105.48 - Reimbursement for durable medical equipment
Section 14105.485 - [Repealed]
Section 14105.49 - List of Healthcare Common Procedure Coding System (HCPCS) codes
Section 14105.5 - Health facility securing license covering new facility or additional bed capacity or conversion to different license category
Section 14105.51 - Capped rental for reimbursement for durable medical equipment
Section 14105.6 - Construction of project and failure to obtain certificate of need covering project
Section 14105.65 - [Repealed]
Section 14105.7 - Updating drug product prices after receiving notice of price change
Section 14105.75 - Utilization controls for drug products in injectable form not administered by patient
Section 14105.8 - Enteral nutrition products used to prevent disability or death in patients with conditions precluding regular food
Section 14105.85 - Payment for enteral nutrition products dispensed by pharmacy
Section 14105.86 - Reimbursement for blood factors
Section 14105.91 - [Repealed]
Section 14105.915 - [Repealed]
Section 14105.916 - [Repealed]
Section 14105.94 - Supplemental reimbursement for ground emergency medical transportation
Section 14105.945 - Public Provider Intergovernmental Transfer Program
Section 14105.95 - Supplemental reimbursement for adult day health services
Section 14105.96 - Supplemental reimbursement for outpatient services
Section 14105.965 - [Repealed]
Section 14105.97 - Outpatient disproportionate share factor for hospitals
Section 14105.98 - Payment adjustment amounts paid to hospitals
Section 14105.981 - [Inoperative]
Section 14105.982 - Emergency regulations to specify process for preparation and issuance
Section 14105.985 - Disproportionate share payment augmentation programs
Section 14105.986 - Evaluation of children's hospital for eligibility for payments
Section 14105.99 - Reduction of appropriation for and distribution of payments pursuant to Attachment 4.19-A
Section 14106 - Rate payment negotiated by provider lower than or equal to reasonable costs, customary charges, etc.
Section 14106.2 - Gifts, grants or endowments received by provider or investment income earned
Section 14106.6 - Rate schedule of reimbursement for paramedic services
Section 14107 - False or fraudulent activities
Section 14107.1 - Improper claims submitted on behalf of provider
Section 14107.11 - Payment suspension
Section 14107.12 - Reward paid to person furnishing information leading to recovery of public funds
Section 14107.13 - Notice to confirm fee-for-service
Section 14107.2 - Solicitation or payment of kickback, bribe or rebate
Section 14107.3 - Charging, accepting or receiving consideration as precondition for providing services or merchandise
Section 14107.4 - False cost reports
Section 14107.5 - Rescission of durable medical equipment or incontinence supplies provider's privileges
Section 14108 - Developmentally disabled recipient entitled to be absent from facility
Section 14108.1 - Recipient receiving mental health treatment entitled to be absent from facility
Section 14108.2 - Resident of long-term care facility permitted temporary absence
Section 14109 - Cost of deductibles or cost sharing charge considered
Section 14109.5 - Reimbursement rate for costs specified in section 14109
Section 14109.6 - Reimbursement rate for costs specified in section 14109
Section 14110 - Requirements for payment to medical or health care facility
Section 14110.05 - Assistance to nursing facility applicants
Section 14110.1 - Reimbursements for long-term care in hospital
Section 14110.15 - Collection and maintenance of data elements in minimum data set specified by federal government
Section 14110.2 - Amendment of state plan to conform to decision of Legislature
Section 14110.3 - Intermediate care in nursing homes
Section 14110.4 - Landry services for developmentally disabled
Section 14110.5 - Standards for ophthalmic device
Section 14110.55 - Reimbursement rate for continuous skilled nursing care services provided to developmentally disabled
Section 14110.6 - Payment rates for skilled nursing or intermediate care services provided developmentally disabled
Section 14110.65 - [Repealed]
Section 14110.7 - Number of equivalent nursing hours per patient
Section 14110.8 - Signature or cosignature of responsible party as condition of admission
Section 14110.9 - Security deposit
Section 14111 - Delegation to nurse practitioner
Section 14111.5 - Tasks performed by nurse practitioner in long-term health care facility
Section 14112 - Health care not lien
Section 14113 - Cooperative arrangements with Department of Rehabilitation
Section 14114 - Proposition 56 Medi-Cal Physicians and Dentists Loan Repayment Act
Section 14115 - Time for submission of bills for service
Section 14115.1 - Combined charge submitted by hospital based physician
Section 14115.2 - Monthly billing by facilities for developmentally disabled
Section 14115.3 - Independent billing by nurse anesthetist
Section 14115.4 - Payment for pathology services restricted to provider performing services
Section 14115.41 - Claims for reimbursement by laboratory performing services
Section 14115.5 - Enforcement of money judgment or other legal process
Section 14115.6 - [Repealed]
Section 14115.7 - Reimbursement through electronic transfer of funds
Section 14115.75 - Compliance by provider with federal False Claims Act employee training and policy requirements
Section 14115.8 - Billing option for services by local educational agencies (LEAs)
Section 14116 - Delegation by county agency director to employee decision to authorize or deny aid
Section 14117 - Disclosure of medication information
Section 14119 - Employment of consultants
Section 14120 - Monthly schedule of anticipated payments; report
Section 14122 - Care and treatment provided by out-of-state providers
Section 14123 - Suspension of provider participation
Section 14123.05 - Meeting and conferring after notice of payment suspension
Section 14123.1 - Declaratory of existing law
Section 14123.2 - Grounds for civil money penalty
Section 14123.25 - Imposition of mandatory and permissive exclusions; immediate sanctions; warning notice
Section 14124 - Disclosure of information obtained as result of investigation to authoring authority
Section 14124.1 - Records of service rendered
Section 14124.2 - Examination of books and records and inspection of premises or facilities
Section 14124.3 - Signing notice of act, mailing
Section 14124.4 - Review of penalty by director
Section 14124.5 - Rules and regulations
Section 14124.6 - Persons authorized to hear oral argument or hearing for reinstatement or reduction of penalty
Section 14124.7 - Eviction or transfer of resident for changing from private payment or Medicare to Medi-Cal
Section 14124.10 - [Effective Until 1/1/2025] Discrimination against Medi-Cal patient
Section 14124.10 - [Effective 1/1/2025] Discrimination against Medi-Cal patient
Section 14124.11 - Pilot program to utilize federal Public Assistance Reporting Information System (PARIS)
Section 14124.12 - Implementation of waivers or flexibility during COVID-19 emergency period
Section 14124.13 - Contracts for administering or implementing federal grants
Section 14124.14 - Solicitation of grant to develop community-based crisis response plan
Section 14124.15 - Supplemental payment program for emergency medical air transportation services
Section 14124.16 - Independent analysis on network adequacy to obtain federal approval for a Medi-Cal benefit