§ 14131 The Medi-Cal Benefits Program comprises a department-administered …
§ 14131.05 (a) Notwithstanding any other provision of this chapter or …
§ 14131.10 (a) Notwithstanding this chapter, Chapter 8 (commencing with …
§ 14131.11 (a) Notwithstanding any other provision of this chapter or …
§ 14131.15 (a) In geographic areas in which Medi-Cal managed care plans …
§ 14132 The following is the schedule of benefits under this …
§ 14132.01 (a) Notwithstanding any other provision of law, a community …
§ 14132.02 (a) The department shall seek approval from the United States …
§ 14132.03 (a) The following shall be covered Medi-Cal benefits effective …
§ 14132.05 The department shall provide the fiscal and appropriate policy …
§ 14132.06 (a) Services specified in this section that are provided by a …
§ 14132.07 (a) A Medi-Cal managed care plan shall not restrict the choice …
§ 14132.09 (a) By July 1, 2024, biomarker testing, as specified in this …
§ 14132.1 As used in this chapter “surgical center” means a surgical clinic …
§ 14132.10 v2 (a) (1) Pediatric day health care provided by a health …
§ 14132.100 v3 (a) The federally qualified health center services described in …
§ 14132.101 (a) Notwithstanding paragraphs (4) and (5) of subdivision (e) of …
§ 14132.102 (a) With the exception of clinics and hospital outpatient …
§ 14132.107 Claims for reimbursement under subdivision (e) of Section 14132.100 …
§ 14132.108 Notwithstanding any other provision of law, requests for rate …
§ 14132.11 (a) Commencing on July 1, 2024, pharmacogenomic testing shall be …
§ 14132.15 For purposes of subdivision (p) of Section 14132, “rehabilitation …
§ 14132.16 Mammography for screening or diagnostic purposes upon the referral of …
§ 14132.17 Annual cervical cancer tests for screening or diagnostic purposes, …
§ 14132.171 (a) (1) An annual cognitive health assessment for Medi-Cal …
§ 14132.18 (a) Community supported living arrangement services approved by …
§ 14132.19 (a) (1) The department, in consultation with the State …
§ 14132.195 (a) Consistent with federal law, screening services provided as …
§ 14132.20 (a) The department shall establish a program to provide …
§ 14132.21 The department shall assess the feasibility of applying to the …
§ 14132.22 (a) For purposes of this section, dental restorative materials …
§ 14132.23 (a) (1) Except as set forth in paragraph (2), and …
§ 14132.24 (a) No later than April 1, 2023, and until June 30, 2025, the …
§ 14132.25 (a) On or before July 1, 1983, the State Department of Health …
§ 14132.26 (a) The department shall develop a program that requires a …
§ 14132.27 (a) (1) The department shall apply for a waiver of federal …
§ 14132.275 (a) The department shall seek federal approval to establish the …
§ 14132.276 For nursing facility services provided under the demonstration …
§ 14132.277 (a) For purposes of this section, the following definitions …
§ 14132.28 (a) If the department decides to terminate or not renew a health …
§ 14132.29 (a) A health facility that has a subacute services provider …
§ 14132.3 In addition to any other criteria as provided in subdivision (p) of …
§ 14132.34 (a) Human milk and human milk derivatives supplied by a mothers’ …
§ 14132.35 (a) Outpatient rehabilitation services are covered under this …
§ 14132.36 (a) Community health worker services are a covered Medi-Cal …
§ 14132.39 Midwifery services provided by a licensed midwife shall be covered …
§ 14132.4 Nurse-midwifery services provided by a certified nurse-midwife shall …
§ 14132.41 (a) Services provided by a certified nurse practitioner shall be …
§ 14132.42 Benefits under this chapter shall not be restricted for inpatient …
§ 14132.44 (a) Targeted case management (TCM), pursuant to Section 1915(g) …
§ 14132.45 Regulations implementing, interpreting, or making specific the …
§ 14132.46 Pursuant to Sections 14024 and 14124.90, the Director of Health …
§ 14132.47 (a) It is the intent of the Legislature to provide local …
§ 14132.48 Targeted case management services to which Sections 14132.44 and …
§ 14132.49 (a) Upon federal approval of the state plan amendments made …
§ 14132.55 For the purposes of reimbursement under the Medi-Cal program, a …
§ 14132.56 (a) (1) Only to the extent required by the federal …
§ 14132.57 (a) (1) The department shall seek all necessary federal …
§ 14132.58 (a) The department shall file all necessary state plan …
§ 14132.6 External prostheses constructed of silicon or other comparable …
§ 14132.62 (a) Reconstructive surgery shall be covered under this chapter, …
§ 14132.63 (a) An orthotist or prosthetist providing services under this …
§ 14132.69 (a) Notwithstanding any other provision of law, donor and …
§ 14132.70 (a) A Medi-Cal beneficiary shall remain eligible to receive …
§ 14132.71 (a) For purposes of donor and recipient organ transplant …
§ 14132.72 (a) For purposes of this section, the definitions in subdivision …
§ 14132.723 (a) (1) Notwithstanding any other law, neither face-to-face …
§ 14132.724 (a) On or before July 1, 2020, the department shall issue, and …
§ 14132.725 (a) For purposes of this section, the following definitions …
§ 14132.73 The State Department of Health Care Services shall allow …
§ 14132.731 (a) A county that enters into a Drug Medi-Cal Treatment Program …
§ 14132.74 (a) The department, in consultation with interested …
§ 14132.75 (a) In enacting this section, it is the intent of the …
§ 14132.755 (a) Commencing no sooner than July 1, 2022, dyadic behavioral …
§ 14132.76 (a) An individual who is determined to be eligible to receive …
§ 14132.765 (a) No treatment authorization request shall be required for the …
§ 14132.77 (a) (1) Any rural hospital may request to participate in a …
§ 14132.8 Services covered under this chapter shall include rehabilitative …
§ 14132.81 (a) The purchase of identification bracelets for eligible …
§ 14132.85 (a) For purposes of this section, the following definitions …
§ 14132.86 (a) Notwithstanding subdivision (ab) of Section 14132, effective …
§ 14132.88 (a) Notwithstanding subdivision (h) of Section 14132 and to the …
§ 14132.89 (a) Notwithstanding subdivision (h) of Section 14132, effective …
§ 14132.9 Notwithstanding subdivision (h) of Section 14132, any utilization …
§ 14132.905 (a) Day care habilitative services, pursuant to subdivision (c) …
§ 14132.91 (a) Subject to the availability of funding, the department shall …
§ 14132.915 (a) (1) The department shall establish a list of …
§ 14132.92 (a) Notwithstanding subdivision (a) of Section 4512, or any …
§ 14132.925 (a) (1) Notwithstanding any other provision of law or …
§ 14132.93 It is the intent of the Legislature that if services meeting the …
§ 14132.94 (a) Subject to approval by the Centers for Medicare and Medicaid …
§ 14132.95 (a) Personal care services, when provided to a categorically …
§ 14132.951 (a) It is the intent of the Legislature that the State …
§ 14132.952 (a) The department shall seek approval of an amendment to the …
§ 14132.955 Personal care services that are provided pursuant to Section 14132.95 …
§ 14132.956 (a) The department shall assess and determine whether it would …
§ 14132.96 Medi-Cal personal care services provider rates established as …
§ 14132.966 (a) Services provided by a physician assistant are a covered …
§ 14132.968 (a) (1) Pharmacist services are a benefit under the …
§ 14132.969 (a) Subject to an annual appropriation for this express purpose, …
§ 14132.97 (a) (1) For purposes of this section, “waiver personal care …
§ 14132.971 (a) The county, or the public authority or nonprofit consortium …
§ 14132.98 (a) For a beneficiary diagnosed with cancer and accepted into a …
§ 14132.985 For services provided pursuant to Chapter 7 (commencing with Section …
§ 14132.99 (a) For the purposes of this section, “facility residents” means …
§ 14132.991 (a) When renewing the Nursing Facility/Acute Hospital Transition …
§ 14132.993 (a) This section applies to the Home- and Community-Based …
§ 14132aa (a) Services provided by facilities licensed as congregate …
§ 14133 Utilization controls that may be applied to the services set forth in …
§ 14133.01 (a) Notwithstanding any other law, the director or his or her …
§ 14133.05 (a) Notwithstanding any other provision of law, a request for a …
§ 14133.07 (a) A doctor of podiatric medicine shall not be required to …
§ 14133.1 (a) The director shall determine which of the utilization …
§ 14133.10 v2 (a) Where it is expected to be cost-effective, the director may, …
§ 14133.12 (a) The director shall apply utilization controls to continuous …
§ 14133.14 The criteria that the department shall use to identify providers to …
§ 14133.15 (a) The provision of services to beneficiaries eligible for …
§ 14133.16 (a) Notwithstanding subdivision (l) of Section 14132, hearing …
§ 14133.2 (a) The director shall include in the Medi-Cal list of contract …
§ 14133.225 Notwithstanding any other law, the department shall not provide or …
§ 14133.23 (a) To the extent that federal financial participation is not …
§ 14133.25 (a) The director shall identify those surgical and medical …
§ 14133.3 (a) The director shall require fully documented medical …
§ 14133.37 For drugs covered under this chapter requiring prior authorization, …
§ 14133.4 Notwithstanding any other provision of law, utilization controls …
§ 14133.45 (a) Utilization controls adopted by the department shall not …
§ 14133.6 In acting upon prior authorization requests for nonemergency medical …
§ 14133.65 Prior authorization for the use of nonemergency medical …
§ 14133.7 The department shall not require emergency certification statements …
§ 14133.8 (a) A bone marrow transplant for the treatment of cancer for …
§ 14133.85 (a) (1) Except as otherwise provided in this subdivision, …
§ 14133.9 The implementation of prior authorization permitted by subdivision …
§ 14134.2 The reimbursement rate for any three or more laboratory services for …
§ 14134.25 (a) Tobacco cessation services are covered benefits under the …
§ 14134.5 All of the following requirements apply to the provision of services …
§ 14134.55 The department shall streamline and simplify existing Medi-Cal …
§ 14134.6 Long-term health care facilities may charge a resident only the …
§ 14135 To assure maximum federal financial participation under this chapter, …
§ 14136 (a) No city or county shall establish equipment and personnel …
§ 14136.1 It is the intent of the Legislature that, in order for payment to be …
§ 14136.3 No prior authorization shall be necessary for the provision of …
§ 14136.4 A written treatment authorization request for nonemergency medical …
§ 14136.5 No entity which has received funds under paragraph (2) of subsection …
§ 14136.8 No reimbursement shall be made for medical transportation services …
§ 14137 The State Department of Health Services, following review and …
§ 14137.6 (a) Notwithstanding any other provision of law, and subject to …
§ 14137.8 Approval of a request for acute inpatient care shall be solely …
§ 14138 (a) To the extent permitted by federal law, the department shall …

Terms Used In California Codes > Welfare and Institutions Code > Division 9 > Part 3 > Chapter 7 > Article 4 - The Medi-Cal Benefits Program

  • Adjourn: A motion to adjourn a legislative chamber or a committee, if passed, ends that day's session.
  • Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • 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.
  • Appellate: About appeals; an appellate court has the power to review the judgement of another lower court or tribunal.
  • Appraisal: A determination of property value.
  • Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
  • Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
  • Balanced budget: A budget in which receipts equal outlays.
  • 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
  • City: includes "city and county" and "incorporated town. See California Streets and Highways Code 15
  • Clerk of court: An officer appointed by the court to work with the chief judge in overseeing the court's administration, especially to assist in managing the flow of cases through the court and to maintain court records.
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Construction: includes :

    California Streets and Highways Code 29

  • Contract: A legal written agreement that becomes binding when signed.
  • 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
  • Deed: The legal instrument used to transfer title in real property from one person to another.
  • Defendant: In a civil suit, the person complained against; in a criminal case, the person accused of the crime.
  • department: means the State Department of Health Services. See California Welfare and Institutions Code 14062
  • Department: means the Department of Transportation of this state. See California Streets and Highways Code 20
  • Dependent: A person dependent for support upon another.
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Dismissal: The dropping of a case by the judge without further consideration or hearing. Source:
  • Donor: The person who makes a gift.
  • Entitlement: A Federal program or provision of law that requires payments to any person or unit of government that meets the eligibility criteria established by law. Entitlements constitute a binding obligation on the part of the Federal Government, and eligible recipients have legal recourse if the obligation is not fulfilled. Social Security and veterans' compensation and pensions are examples of entitlement programs.
  • 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.
  • Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
  • 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.
  • Foreclosure: A legal process in which property that is collateral or security for a loan may be sold to help repay the loan when the loan is in default. Source: OCC
  • Fraud: Intentional deception resulting in injury to another.
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • Interest rate: The amount paid by a borrower to a lender in exchange for the use of the lender's money for a certain period of time. Interest is paid on loans or on debt instruments, such as notes or bonds, either at regular intervals or as part of a lump sum payment when the issue matures. Source: OCC
  • 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.
  • 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
  • Legislative session: That part of a chamber's daily session in which it considers legislative business (bills, resolutions, and actions related thereto).
  • Lien: A claim against real or personal property in satisfaction of a debt.
  • 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.
  • official grade: when used in this division shall mean the grade so established, changed, or modified. See California Streets and Highways Code 5150.5
  • Oversight: Committee review of the activities of a Federal agency or program.
  • 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
  • Plaintiff: The person who files the complaint in a civil lawsuit.
  • 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.
  • Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
  • Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
  • 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.
  • roadbed: includes that portion of any street used by the track of any railroad between the rails and for two feet on each side thereof and between the tracks if there is more than one, and includes the rails of such track or tracks. See California Streets and Highways Code 6751
  • 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.
  • Spouse: includes "registered domestic partner" as required by §. See California Welfare and Institutions Code 12.2
  • Statute: A law passed by a legislature.
  • Statute of limitations: A law that sets the time within which parties must take action to enforce their rights.
  • Summons: Another word for subpoena used by the criminal justice system.
  • surgical center: means a surgical clinic that is licensed under §. See California Welfare and Institutions Code 14132.1
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
  • Verdict: The decision of a petit jury or a judge.
  • Writ: A formal written command, issued from the court, requiring the performance of a specific act.