Last updated: 7/21/2025
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). This is a mandatory contract between an applicant or existing provider and the California Department of Health Care Services (DHCS) for enrollment or continued participation in the Medi-Cal program. This form is used to formally affirm that the provider agrees to comply with all applicable federal and state laws, regulations, and program requirements governing the delivery of services to Medi-Cal beneficiaries. It includes provisions related to licensing, billing, recordkeeping, confidentiality, non-discrimination, fraud prevention, inspections, and penalties for noncompliance. By completing and signing this agreement, the provider commits to delivering services in accordance with Medi-Cal standards and acknowledges that any violation may result in suspension or termination from the program. The agreement is legally binding and must be completed in full, with corrections properly initialed, and, if required, notarized. www.FormsWorkflow.com
