California
Statewide
Medi Cal
Last updated: 5/5/2017
Medi-Cal Disclosure Statement {DHS-6207}
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Description
DHCS 6207 , MEDI-CAL DISCLOSURE STATEMENT, Every applicant or provider must complete and submit a current Medi-Cal Disclosure Statement (DHCS 6207) as part of a complete application package for enrollment, continued enrollment, or certification as a Medi-Cal provider. Overall Authority: Code of Federal Regulations, Title 42, Part 455; California Code of Regulations, Title 22, Sections 51000-51451; Welfare and Institutions Code, Sections 14043-14043.75. www.FormsWorkflow.com
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