Last updated: 9/27/2021
Medi-Cal Provider Agreement {DHS-6208}
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Description
DHCS 6208, MEDI-CAL PROVIDER AGREEMENT, (To Accompany Applications for Enrollment or Continued Enrollment), Every applicant and provider must execute this Provider Agreement, except physicians, who must execute the “Medi-Cal Physician Application/Agreement,” DHCS 6210. EXECUTION OF THIS PROVIDER AGREEMENT BETWEEN AN APPLICANT OR PROVIDER (HEREINAFTER JOINTLY REFERRED TO AS “PROVIDER”) AND THE DEPARTMENT OF HEALTH CARE SERVICES (HEREINAFTER “DHCS”), IS MANDATORY FOR PARTICIPATION OR CONTINUED PARTICIPATION AS A PROVIDER IN THE MEDI-CAL PROGRAM PURSUANT TO 42 UNITED STATES CODE, SECTION 1396a(a)(27), TITLE 42, CODE OF FEDERAL REGULATIONS, SECTION 431.107, WELFARE AND INSTITUTIONS CODE, SECTION 14043.2, AND TITLE 22, CALIFORNIA CODE OF REGULATIONS, SECTION 51000.30(a)(2). www.FormsWorkflow.com
