Article 6 - Eligibility for Payment

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 [Repealed]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 [Repealed]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 [Repealed]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 [Repealed]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 [Repealed]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 [Repealed]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 [Repealed]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 [Repealed]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 [Repealed]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 [Repealed]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 [Repealed]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 [Repealed]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