Terms Used In California Codes > Welfare and Institutions Code > Division 9 > Part 3 > Chapter 7 > Article 1.3 - Provider Enrollment, Application, and Participation

• Abuse: means either of the following:

  California Welfare and Institutions Code 14043.1

• Activities: means , but is not limited to, all of the following:

  California Streets and Highways Code 36705

• Allegation: something that someone says happened.
• Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
• Applicant: means an individual, including an ordering, referring, or prescribing individual, partnership, group, association, corporation, institution, or entity, and the officers, directors, owners, managing employees, or agents thereof, that apply to the department for enrollment as a provider in the Medi-Cal program. See California Welfare and Institutions Code 14043.1
• Appropriate volume of business: means a volume that is consistent with the information provided in the application and any supplemental information provided by the applicant or provider, and is of a quality and type that would reasonably be expected based upon the size and type of business operated by the applicant or provider. See California Welfare and Institutions Code 14043.1
• Assessment: means a levy for the purpose of acquiring, constructing, installing, or maintaining improvements and promoting activities which will benefit the properties or businesses located within a multifamily improvement district. See California Streets and Highways Code 36705
• Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
• Bail: Security given for the release of a criminal defendant or witness from legal custody (usually in the form of money) to secure his/her appearance on the day and time appointed.
• Baseline: Projection of the receipts, outlays, and other budget amounts that would ensue in the future without any change in existing policy. Baseline projections are used to gauge the extent to which proposed legislation, if enacted into law, would alter current spending and revenue levels.
• Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. ^{Source: OCC}
• Business: means all types of businesses, including, but not limited to, the operation of multifamily residential properties, retail stores, commercial properties, financial institutions, and professional offices. See California Streets and Highways Code 36705
• Business address: means the location where an applicant or provider provides services, goods, supplies, or merchandise, directly or indirectly, to a Medi-Cal beneficiary. See California Welfare and Institutions Code 14043.1
• City: means a city, county, city and county, or an agency or entity created pursuant to the Joint Exercise of Powers Act, Article 1 (commencing with Section 6500) of Chapter 5 of Division 7 of Title 1 of . See California Streets and Highways Code 36705
• City: includes "city and county" and "incorporated town. See California Streets and Highways Code 15
• City council: means the city council of a city or the board of supervisors of a county, or the agency, commission, or board created pursuant to a joint powers agreement and which is a city within the meaning of this part. See California Streets and Highways Code 36705
• Clerk: means clerk of the legislative body. See California Streets and Highways Code 36705
• Construction: includes :

  California Streets and Highways Code 29

• Contract: A legal written agreement that becomes binding when signed.
• Convicted: means any of the following:

  California Welfare and Institutions Code 14043.1

• Conviction: A judgement of guilt against a criminal defendant.
• Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
• County: includes "city and county. See California Welfare and Institutions Code 14
• County: includes "city and county. See California Streets and Highways Code 14
• county highway: means any highway which is:

  California Streets and Highways Code 25

• Debt due and owing: means 60 days have passed since a notice or demand for repayment of an overpayment or another amount resulting from an audit or examination, for a penalty assessment, or for another amount due to the department was sent to the provider, regardless of whether the provider is an institutional provider or a noninstitutional provider and regardless of whether an appeal is pending. See California Welfare and Institutions Code 14043.1
• department: means the State Department of Health Services. See California Welfare and Institutions Code 14062
• director: means the State Director of Health Services. See California Welfare and Institutions Code 14061
• Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
• district: means a multifamily improvement district established pursuant to this part. See California Streets and Highways Code 36705
• Division: means permanent road division. See California Streets and Highways Code 1160
• Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
• Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
• Fraud: Intentional deception resulting in injury to another.
• Fraud: means an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to himself or herself or some other person. See California Welfare and Institutions Code 14043.1
• Highway: means any county road or highway or any public roadway right of way or any private easement or roadway not accepted or acceptable into the county highway system but upon which a permanent public easement is offered or any privately owned road which meets the requirements of and in connection with which the necessary findings of Section 969. See California Streets and Highways Code 1160
• highway: includes bridges, culverts, curbs, drains, and all works incidental to highway construction, improvement, and maintenance. See California Streets and Highways Code 23
• Improvement: means the acquisition, construction, installation, or maintenance of any tangible property with an estimated useful life of five years or more, including, but not limited to:

  California Streets and Highways Code 36705

• Individual dentist practice: means a dentist licensed by the Dental Board of California enrolled or enrolling in Medi-Cal as an individual provider who is a sole proprietor of his or her practice or is a corporation owned solely by the individual dentist and the only dentist practitioner is the owner. See California Welfare and Institutions Code 14043.1
• Individual physician practice: means a physician and surgeon licensed by the Medical Board of California or the Osteopathic Medical Board of California enrolled or enrolling in Medi-Cal as an individual provider who is sole proprietor of his or her practice or is a corporation owned solely by the individual physician and the only physician practitioner is the owner. See California Welfare and Institutions Code 14043.1
• Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
• Last equalized assessment roll: means the last assessment roll made up by the county assessor, including the changes ordered by the board of supervisors sitting as a board of equalization. See California Streets and Highways Code 1160
• Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). ^{Source: OCC}
• Lien: A claim against real or personal property in satisfaction of a debt.
• Location: means a street, city, or rural route address or a site or place within a street, city, or rural route address, and the city, county, state, and nine-digit ZIP Code. See California Welfare and Institutions Code 14043.1
• maintenance: includes any of the following:

  California Streets and Highways Code 27

• Medi-Cal: means the California Medical Assistance Program. See California Welfare and Institutions Code 14063
• Nolo contendere: No contest-has the same effect as a plea of guilty, as far as the criminal sentence is concerned, but may not be considered as an admission of guilt for any other purpose.
• Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
• owner: means any person shown as the owner of land on the last equalized assessment roll or otherwise known to be the owner of land by the city council. See California Streets and Highways Code 36705
• Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
• Person: means any person, firm, partnership, association, corporation, organization, limited liability company, or business trust. See California Streets and Highways Code 19
• Personal property: All property that is not real property.
• plan: means a proposal as described in Section 36713. See California Streets and Highways Code 36705
• Plea: In a criminal case, the defendant's statement pleading "guilty" or "not guilty" in answer to the charges, a declaration made in open court.
• preenrollment: includes the period of time during which an application package for enrollment, continued enrollment, or for the addition of or change in a location is pending. See California Welfare and Institutions Code 14043.1
• Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
• Professionally recognized standards of health care: means statewide or national standards of care, whether in writing or not, that professional peers of the individual or entity whose provision of care is an issue recognize as applying to those peers practicing or providing care within a state. See California Welfare and Institutions Code 14043.1
• Property: means real property situated within a multifamily improvement district. See California Streets and Highways Code 36705
• Provider: means an individual, partnership, group, association, corporation, institution, or entity, and the officers, directors, owners, managing employees, or agents of a partnership, group association, corporation, institution, or entity, that provides services, goods, supplies, or merchandise, directly or indirectly, including all ordering, referring, and prescribing, to a Medi-Cal beneficiary and that has been enrolled in the Medi-Cal program. See California Welfare and Institutions Code 14043.1
• Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
• Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
• Resolution of an investigation for fraud or abuse: means there is no documentation to indicate either that a charge or accusation has been filed against the provider and either (1) the investigation has not been active at any time during the previous 12 months or (2) the department has made a documented good faith effort and has been unable, for a period of 12 months, to contact an investigator or responsible representative of any agency investigating the provider. See California Welfare and Institutions Code 14043.1
• Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
• Statute: A law passed by a legislature.
• Testimony: Evidence presented orally by witnesses during trials or before grand juries.
• Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.