Dhcs 6207 2011 form-2025

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53 votes

The document outlines the requirements for completing and submitting a Medi-Cal Disclosure Statement (DHCS 6207) for applicants or providers seeking enrollment, continued enrollment, or certification as Medi-Cal providers in California. It emphasizes the importance of providing complete and accurate information to avoid denial of enrollment or deactivation of business addresses, along with potential reapplication bars. The document includes detailed instructions on filling out various sections related to applicant/provider information, ownership interests, managing control information, subcontractors, and specific requirements for pharmacy applicants. It also highlights the legal authority governing these regulations and provides privacy statements regarding the handling of personal information.

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2014	4.9 Satisfied (212 Votes)
2011	4.2 Satisfied (53 Votes)

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