Reminder to Register NPI with Medi-CalProviders must register their National Provider Identifier (NPI) with Medi-Cal using one of the three methods listed below, if they have not already done so. The deadline to register NPIs with Medi-Cal is November 25, 2007. Providers who are already registered but need to update their information may do so only through November 16, 2007.

Note: Although Medi-Cal plans to participate in the National Plan and Provider Enumeration System (NPPES) data dissemination process, it is not Medi-Cal’s intention to use the data to replace the current NPI registration process. Medi-Cal intends to use the data only to validate NPIs already registered.

The three methods to register are as follows:

National Provider Identifier Collection (NPIC) tool – This tool allows NPIs to be registered one at a time, quickly and for free. Providers access the NPIC through the Medi-Cal Web site (www.medi-cal.ca.gov) by clicking the “NPI” link under “Provider Resources” and then the “Register/Update/Inquire NPIs” link that appears in the NPI Resources box.

NPI Bulk Registration Tool (BRT) – This tool is available to providers who would prefer to register multiple NPIs at the same time using the NPIC online system. Providers may access information about the NPI BRT and technical requirements through the Medi-Cal Web site (www.medi-cal.ca.gov) by clicking the “NPI” link under “Provider Resources” and then the “Register/Update/Inquire NPIs” link that appears in the NPI Resources box.

NPI paper registration – The paper registration process is intended for providers who do not have Internet access. The NPI Registration Form is available through the Telephone Service Center (TSC) at 1-800-541-5555. After completing the required information, providers return their form, along with their NPPES verification document, to the address at the bottom of the form.

Cutoff Date Extension for Old Claim FormsBeginning September 17, 2007, claims received on the old HCFA 1500 or UB-92 claim forms will be rejected and returned to the provider. Providers must submit claims on the new CMS-1500 or UB-04 claim forms to avoid rejection.

Medi-Cal implemented the use of the CMS-1500 and UB-04 claim forms on June 25, 2007. Providers who previously submitted claims on the HCFA 1500 or the UB-92 claim forms were instructed to discontinue using those forms and instead, bill on the new CMS-1500 or UB-04 claim form immediately.

Please see Cutoff Date Extension, page 3

1

September 2007

ContentsReminder to Register NPI

with Medi-Cal.............................1

Cutoff Date Extension for Old Claim Forms........................1

Use of Social Security Numbersfor Billing Prohibited Beginning February 1, 2008.......................3

POS Device Benefits......................4

SCPI Manual Available Soon on the Medi-Cal Web Site..........5

County Organized Health System: Psychiatric Drug Correction.........................5

Family PACT Provider Enrollment Contact Information Update....................5

RAD Correlation Table Updates...........................5

AEVS: Carrier Codes Update.........6

Medi-Cal S&I Provider List..............6

Border Providers.......................................................................................................................... (916) 636-1200CDHS Medi-Cal Fraud Hotline....................................................................................................1-800-822-6222Telephone Service Center (TSC)...............................................................................................1-800-541-5555Provider Telecommunications Network (PTN).........................................................................1-800-786-4346

EDS PO Box 13029 Sacramento, CA 95813-4029

For a complete listing of specialty programs and hours of operation, please refer to the Medi-Cal Directory in the provider manual.

Opt Out is a service designed to save time and increase Medi-Cal accessibility. A monthly e-mail containing direct Web links to current bulletins, manual page updates, training information, and more is now available. Simply “opt out” of receiving this same information on paper, through standard mail. To download the Opt Out enrollment form or for more information, go to the Medi-Cal Web site at www.medi-cal.ca.gov, and click the “Learn how...” link under OPT OUT on the right side of the home page.

2

EDS/MEDI-CAL

Stop Illegal Tobacco SalesThe simplest way to stop illegal tobacco sales to minors is for merchants to check ID and verify the age of

the tobacco purchasers. Report illegal tobacco sales to 1-800-5-ASK-4-ID.

For more information, see the California Department of Health Services Web site at http://www.dhs.ca.gov.

MEDI-CAL FRAUDIS AGAINST THE

LAW

MEDI-CAL FRAUD COSTS TAXPAYERS MILLIONSEACH YEAR AND CAN ENDANGERTHE HEALTH OF CALIFORNIANS.

HELP PROTECT MEDI-CAL AND YOURSELFBY REPORTING YOUR OBSERVATIONS TODAY.

PCDHS MEDI-CAL FRAUD HOTLINE

1-800-822-6222

THE CALL IS FREE AND YOU CAN REMAIN ANONYMOUS.

Knowingly participating in fraudulent activities can result in prosecution and jail time. Help prevent Medi-Cal fraud.

Medi-Cal Update – Program and Eligibility September 2007

Cutoff Date Extension (continued)

Unfortunately, some providers continue to submit claims on the old forms, so the Department of Health Care Services (DHCS) has authorized EDS, the Medi-Cal Fiscal Intermediary, to continue processing claims submitted on the old HCFA 1500 or UB-92 claim forms for a limited time only. The old claim forms will continue to be processed and adjudicated appropriately only through September 16, 2007.

Over-one-year-old claims must also be billed using the new CMS-1500 or UB-04 claim forms beginning September 17, 2007.

As previously published, submission instructions for Claims Inquiry Forms (CIFs) and Appeal Forms require a copy of the corrected original claim form to be attached. Old HCFA 1500 and UB-92 claim forms will only be accepted for this reason.

Use of Social Security Numbers For Billing Prohibited Beginning February 1, 2008Effective for dates of service on or after February 1, 2008, providers may no longer bill Medi-Cal or the Child Health and Disability Prevention (CHDP) program using a recipient’s Social Security Number (SSN). Providers will be required to bill with the Medi-Cal identification number from the recipient’s Benefits Identification Card (BIC) or paper ID card. Claims submitted with a recipient’s SSN for dates of service on or after February 1, 2008 will be denied.

ExceptionsCertain exceptions apply for hospitals, Long Term Care (LTC) facilities, licensed primary care clinics and emergency medical transportation, as indicated by Welfare and Institution Code (W&I Code), Section 14045. The exception criteria will be based primarily on claim type and Place of Service codes.

Eligibility Verification RequirementsEligibility verification should be performed prior to rendering Medi-Cal services. All providers are encouraged to use the Medi-Cal identification number from the recipient’s BIC or paper ID card when verifying eligibility instead of using the recipient’s SSN. If a recipient is unknown to a provider, the provider must make a “good faith effort” to verify the recipient’s identification before rendering services. It is the provider’s responsibility to verify the person’s eligibility and that the person is the individual to whom the card is issued.

In an emergency or if a recipient does not bring a BIC to an appointment, providers may access the Medi-Cal Eligibility Verification System (EVS) and use the recipient’s SSN (with the recipient’s approval) to verify eligibility. Providers are asked to remind recipients that they need to take their BIC with them to the doctor, pharmacy, hospital or any other health care provider. Providers are encouraged to print copies of the Always Take Your BIC With You notice and share them with Medi-Cal patients or the patients’ family members, caretakers or authorized representatives. The notice is available in multiple languages on the Medi-Cal Web site (www.medi-cal.ca.gov). From the home page, click “FAQs” under “Provider Resources,” then click “Recipient Eligibility Verification.”

BIC Information Returned in Eligibility ResponseChanges are also being made to the EVS response message to return BIC information for eligible recipients when the SSN is used to verify eligibility.

Effective September 1, 2007, BIC information will be returned in the eligibility response message for eligibility inquiries submitted using the telephone Automated Eligibility Verification System (AEVS), the Point of Service (POS) device and the Real-Time Internet Eligibility (RTIE) single-subscriber transaction.

Effective for a limited submission period, from January 1, 2008 through January 31, 2008, BIC information will be returned at the end of the eligibility messages within the text message field of batch eligibility submissions. This will allow larger providers, such as hospitals and LTC facilities, the opportunity to update their patient records and databases with the BIC information.

Please see Social Security Numbers, page 4

3

Medi-Cal Update – Program and Eligibility September 2007

Social Security Numbers (continued)

All providers are expected to use the Medi-Cal identification number from the recipient’s BIC or paper ID card when verifying eligibility, billing Medi-Cal or submitting Treatment Authorization Requests (TARs).

Medi-Cal recognizes the importance of protecting the identity and health information of recipients and strongly encourages all providers to avoid using a recipient’s SSN whenever possible.

Please see future Medi-Cal Updates for more information.

POS Device BenefitsPoint of Service (POS) devices provide a quick and easy way for providers to process Medi-Cal claims. They are simple to use and cheaper than a personal computer. POS devices are provided and paid for by the State. Free maintenance and software downloads are included with all POS devices. The only cost to providers is the ongoing purchase of print paper rolls.

POS devices require virtually no assembly. They arrive complete, shipped in one box with electrical components attached to the appropriate items. Set-up is simple: POS devices are plugged directly into a telephone. A common 110-volt AC wall outlet is the only power supply needed.

POS devices are user-friendly, and make filing claims simple. Claims made with POS devices are assigned a Claim Control Number (CCN) right away so that providers can look up claims quickly. They are also equipped for National Provider Identifier (NPI) implementation.

POS devices also a have a range of features and cover a variety of transactions and programs.

Features: 8 lines x 21 characters

128 x 64 pixel graphic liquid crystal display (LCD) with backlighting

Built-in magnetic stripe card reader

Internal printer, with paper installed and ready to use

Easy to use alphanumeric, full-size character keys

Works when the Internet is down

Available Transactions and Programs: ASC X12N version 4010A1 837 professional claim transaction

ASC X12N 270/271 Eligibility Inquiry transaction

Pharmacy claim transaction

Child Health and Disability Prevention (CHDP) Program Gateway

Family PACT (Planning, Access, Care and Treatment)

Share of Cost (Spend Down)

Share of Cost (SOC) Reversal

Medi-Services (Medical Services Reservation)

Medi-Services (MS) Reversal

For more information about POS Devices and service, call the Telephone Service Center (TSC) at1-800-541-5555. When prompted, select option 16, then 16 again.

4

Medi-Cal Update – Program and Eligibility September 2007

SCPI Manual Available Soon on the Medi-Cal Web SiteThe Supplemental Claims Payment Information (SCPI) manual, formerly called the Automated Remittance Data Services (ARDS) manual, is being updated in conjunction with the rollout of National Provider Identifier (NPI) numbers. Two new field names – “Owner Number” and “Provider Type” – will be added to the header of SCPI files.

The manual will soon be available on the Medi-Cal Web site in the “Technical Publications” area. Please check the “What’s New” area of the Medi-Cal Web site home page and futureMedi-Cal Updates for further announcements.

Manual information will be valid for tapes or files created on or after November 19, 2007.

For additional information, or to subscribe to SCPI, providers may contact the SCPI Help Desk at (916) 636-1060 (option 2).

County Organized Health System: Psychiatric Drug CorrectionPsychiatric drugs are not capitated for the following managed care health care plans (HCPs).

Santa Barbara Health Initiative (Santa Barbara County – HCP 502)

Partnership HealthPlan of California (PHC), (Solano County – HCP 504)

June 2007 updates to text under the “Psychiatric Drugs” heading in provider manual sectionMCP: County Organized Health System (COHS) incorrectly stated that psychiatric drugs are capitated for these plans.

Incorrect information has been removed from manual replacement page mcp cohs 7 (Part 1).

Family PACT Provider Enrollment Contact Information UpdateFor provider enrollment assistance, Family PACT prospective providers may contact the Office of Family Planning (OFP) at the California Department of Public Health at 916-650-0285, Monday through Friday, 8 a.m. – 5 p.m.

This updated information is reflected on manual replacement page prov rel 9 (Part 1).

RAD Correlation Table UpdatesEffective October 1, 2007, Health Care Remarks Code (HCRC) N14 will be deactivated.

This information is reflected on manual replacement pages remit elect corr400 1 thru 8 (Part 1) and remit elect corr600 9 (Part 1).

5

Medi-Cal Update – Program and Eligibility September 2007

AEVS: Carrier Codes for Other Health Coverage: September UpdateThe AEVS: Carrier Codes for Other Health Coverage list has been updated. These codes are

updated monthly. For a complete AEVS: Carrier Codes for Other Health Coverage list, visit the Medi-Cal Web site at www.medi-cal.ca.gov. Click the “User Guides” link under “Provider Resources,” then click the “AEVS User Guide” link. Additions and changes are shown in bold and underlined type.

Providers may order a hard copy update of the section by calling the Telephone Service Center (TSC) at 1-800-541-5555. Updates are listed below.

Addition

Code CarrierH414 HAA PREFERRED PARTNERS

Change

Code CarrierN262 ALLIED ADMINISTRATORS

Medi-Cal Suspended and Ineligible Provider List: September UpdateThe Medi-Cal Suspended and Ineligible Provider List (S&I List) has been updated. This list is

updated monthly. For a complete S&I List, visit the Medi-Cal Web site at www.medi-cal.ca.gov and click the “S & I Provider List” link under “Provider Reference.” Providers may also order a hard copy update of the list by calling the Telephone Service Center (TSC) at 1-800-541-5555.

Additions and changes are shown in bold type and reinstated providers are removed from the S&I List. Always refer to the S&I List when verifying provider ineligibility.

6

Physician ( susp A)

Amsden, Neal F. 15208 Suspended28 N. Vista de Catalina indefinitely effectiveLaguna Beach, California 3/26/2007.

Ayres, William Hamilton 8492 Suspended153 N. San Mateo Drive, #409 indefinitely effectiveSan Mateo, California 4/11/2007.

Badr, Mohamed Ibrahim 56397 Suspended703 W. Graham Avenue, #101 indefinitely effectiveLake Elsinore, California 4/12/2007. and1660 E. Herndon Avenue, #127Fresno, California andP.O. Box 5297Fresno, California

Bass, Howard R. 39193 Suspended2136 West 31st Street indefinitely effectiveLos Angeles, California 3/23/2007.

Bedney, Donald L., M.D. 38955 SuspendedP.O. Box 1762 indefinitely effectiveLoma Linda, California 8/7/2007.

Belford, Paul D. 32146 Suspended13631 W. Banff Lane indefinitely effectiveSurprise, Arizona 6/1/2006.

Blee, James Alicante 23208 SuspendedP.O. Box 383 indefinitely effectiveHighland, California 8/1/2006.

Physician ( susp A)

Bradley, Bruce E. 12062 Suspended1555 Mirasol Drive indefinitely effectiveSan Marino, California 9/15/2006.

Bright, Robert C., Jr. 63567 Suspended70 Grace Terrace indefinitely effectivePasadena, California 3/16/2007.

Cerevka, Joseph Michal 26777 SuspendedP.O. Box 5138 indefinitely effectiveBeverly Hills, California 12/15/2006.

Coburn, William M., Jr. 23131 Suspended2220 Lynn Road, #102 indefinitely effectiveThousand Oaks, California 5/30/2007.

DeGregorio, Peter A. 19551 Suspended13652 Cantara Street indefinitely effectivePanorama City, California 12/15/2006.

Grobovsky, Laura Vanini 83628 Suspended1929 Lone Oak Road indefinitely effectiveJohnson City, Tennessee 9/25/2006.

Gross, Joel Alan 44417 SuspendedP.O. Box 1472 indefinitely effectiveLafayette, California 2/21/2007.

Guidry, Paul L., Jr., M.D. 73021 Suspended3701 Stocker Street, #309 indefinitely effectiveLos Angeles, California 2/14/2007.

Please see S&I List, page 7

S&I List (continued)Physician ( susp A)

Hampton, William Wilson 41730 Suspended3505 Long Beach Boulevard, indefinitely effective#1D 5/29/2007.Long Beach, California

Holloman, John D. 24131 Suspended1425 S. Main Street indefinitely effectiveWalnut Creek, California 1/31/2007. and500 Mountain ViewSan Luis Obispo, California

Hubbard, Derick S. 69055 Suspended445 S. Figueroa Street, #2600 indefinitely effectiveLos Angeles, California 8/23/2007. and234 S. Figueroa Street, #425Los Angeles, California and2220 E. Anaheim StreetLong Beach, California and11200 Wilmington AvenueLos Angeles, California

Lee, Robert 59662 Suspended419 6th Avenue SW indefinitely effectiveRochester, Minnesota 10/2/2006.

Liu, Samantha Landie 77884 Suspended415 N. San Mateo Drive, #3 indefinitely effectiveSan Mateo, California 4/9/2007.

Lotfy, Abdou Maged Micha 49878 Suspended aka: Lotfy-Abdou, Maged indefinitely effective3119 E. Genoa Street, D 1/2/2007.Ontario, California

Nelson, Donald G. 12127 Suspended2108 24th Street, #2 indefinitely effectiveBakersfield, California 6/30/2006. and2901 H Street, #9Bakersfield, California

Osova, Susan Lillian 74655 Suspended1081 N. China Lake Boulevard indefinitely effectiveRidgecrest, California 10/13/2006. and310 Esplanade Avenue, #59Pacifica, California and3303 Harbor Boulevard, #D11Costa Mesa, California

Pasuhuk, Edwin H. 39666 Suspended29122 Amberwood Lane indefinitely effectiveHighland, California 6/23/2007. and895 W. Valley BoulevardColton, California

Physician ( susp A)

Plunkett, Patrick 30729 Suspended300 W. Huntington Drive indefinitely effectiveArcadia, California 5/14/2007. and1231 Blair AvenueS. Pasadena, California and10 Congress Street, #202Pasadena, California

Pollock, William Jack 31161 Suspended1313 East Herndon Avenue, indefinitely effective#105 6/21/2006.Fresno, California and1313 East Herndon Avenue,#101Fresno, California

Rosenblatt, Michael M. 34153 Suspended11100 Warner Avenue, #314 indefinitely effectiveFountain Valley, California 4/9/2007. and1605 Haskell StreetBurlington, Iowa and321 8th Avenue WCresco, Iowa

Vallejo, Arthur, M.D. 64836 Suspended9560 Maple Street indefinitely effectiveBellflower, California 8/23/2007. and17027 Clark AvenueBellflower, California and3650 South Street, #210Lakewood, California andP.O. Box 6289Lakewood, California and21081 S. Western Avenue, #250Torrance, California

Physician Assistant ( susp A)

Pinkston, Charles E. 14875 SuspendedP.O. Box 3685 indefinitely effectiveCerritos, California 8/29/2007.

Marriage and Family Therapist Intern ( susp C)

Oakes, Timothy Wade 40858 Suspended787 Bellhaven Street, #1 indefinitely effectiveJackson, Mississippi 7/19/2007.

Psychologist ( susp C)

Smith, Stephen Jeffrey 8919 Suspended1210 Nevada Street, #101 indefinitely effectiveRedlands, California 12/13/2005.

Pharmaceutical Technician ( susp E)

Gallegos, Kathy Elizabeth 31084 Suspended1761 Almon Avenue indefinitely effectiveMerced, California 7/19/2007.

Please see S&I List, page 8

S&I List (continued)Pharmaceutical Technician ( susp E)

Maldonado, Karen 24314 Suspended126 Fisk Terrace indefinitely effectiveFremont, California 7/19/2007.

Sanchez, Karen Marie 41514 Suspended8170 Westwood Drive, #14 indefinitely effectiveGilroy, California 7/19/2007.

Pharmacist ( susp E)

Residential Care Home 38852 Suspended for You, Inc. indefinitely effective dba: Home Care Pharmacy 2/21/2007.1687 Erringer Road, #101Simi Valley, California and11711 Sterling Avenue ERiverside, California

Wong, Douglas Vernon 50646 Suspended3334 West Caldwell Avenue, indefinitely effective#121 7/19/2007.Visalia, California

Dentist ( susp G)

Ebrahimian, Shahab 44473 Suspended1315 Carla Lane indefinitely effectiveBeverly Hills, California 9/3/2007.

Hanna, Sohair 37334 Suspended8914 S. Vermont Avenue indefinitely effectiveLos Angeles, California 8/29/2007.

Nunez, Pete D. 23654 Suspended3542 East Adams indefinitely effectiveFresno, California 4/5/2007.

Shafa, Farhad 44538 Suspended9313 Monter Mar Drive indefinitely effectiveLos Angeles, California 9/3/2007.

Thi, Hong Nga, D.D.S. 47429 Suspended925 East San Antonio indefinitely effective Drive, #14 4/6/2007.Long Beach, California

Chiropractor ( susp J)

Tutashinda, Kweli 20825 Suspended3358 Adeline Street indefinitely effectiveBerkeley, California 7/19/2007.

Podiatrist ( susp K)

Ainsley, William Todd, D.P.M. 4471 Suspended1755 Purdue Avenue, #109 indefinitely effectiveLos Angeles, California 8/7/2007.

Podiatrist ( susp K)

Graves, Richard H. 3954 Suspended10821 Oxnard Street indefinitely effectiveN. Hollywood, California 6/4/2007. and3791 Katella AvenueLos Alamitos, California and18085 S. 2nd StreetFountain Valley, California

Haddad, Imad Ibrahim 3831 Suspended aka: Imad, Haddad indefinitely effective21307 Romar Street 8/23/2007.Chatsworth, California and1833 E. Imperial HighwayLos Angeles, California andP.O. Box 617Los Angeles, California and715 Foothill BoulevardGlendora, California and1501 Agate StreetColton, California and1420 E. Cooley Drive, #230Colton, California

Home Health Aide ( susp P)

Franklin, Krystal 161556 Suspended794 East Ralston Street indefinitely effectiveSan Bernardino, California 9/20/2005.

Smith, Jeanetta 157682 Suspended7101 Rosecrans Avenue, #38 indefinitely effectiveParamount, California 7/20/2006.

Certified Nurse Assistant ( susp R)

Clemente, Bernard A. 652121 Suspended6488 Crabtree Street indefinitely effectiveSan Diego, California 8/13/2007.

Edinbyrd, Geraldine 17316 Suspended1031 North H Street indefinitely effectiveSan Bernardino, California 5/19/2005.

Erby, Tanya 594184 SuspendedP.O. Box 164 indefinitely effectiveInstitute, West Virginia 4/20/2006.

Escamilla, Eddie 13764 Suspended521 Emory Street indefinitely effectiveImperial Beach, California 3/20/2006.

Escobar, Gladys Mancilla 513674 Suspended aka: Escobar, Gladis Mancilla indefinitely effectiveP.O. Box 5152 9/20/2005.Buena Park, California

Franklin, Krystal 52620 Suspended794 East Ralston Street indefinitely effectiveSan Bernardino, California 9/20/2005.

Please see S&I List, page 9

S&I List (continued)Certified Nurse Assistant ( susp R)

Gabriel, Julio 501476 Suspended3325 Bennett Way indefinitely effectiveConcord, California 1/19/2006.

Gale, Loreta 183154 Suspended116 Palm Avenue, #15 indefinitely effectiveNational City, California 7/20/2005.

Go, Estrellita C. 519608 Suspended1030 Burnham Drive indefinitely effectivePittsburg, California 7/19/2006.

Kindangen, Marietje 685757 Suspended5125 Cambridge Avenue indefinitely effectiveSan Bernardino, California 7/19/2007.

Lapiran, Maria Teresa 546251 Suspended780 Pine Street indefinitely effectiveSan Francisco, California 6/8/2007.

Paredes, Lizette 533804 Suspended140 East Newburgh Street, #28 indefinitely effectiveAzusa, California 10/20/2004.

Porter, Janice C. Suspended1441 Detroit Avenue, #365 indefinitely effectiveConcord, California 8/5/2007.

Rea, Prudencio Balingbing Suspended8522 Corbin Avenue indefinitely effectiveNorthridge, California 8/5/2007.

Reyes, Candelaria 539790 Suspended1019 West Harding Avenue indefinitely effectiveSanta Maria, California 7/20/2006.

Scott, Carolyn 432248 Suspended43514 Gadsen Avenue, #263 indefinitely effectiveLancaster, California 10/20/2004.

Smith, Jeanetta 514602 Suspended7101 Rosecrans Avenue, #38 indefinitely effectiveParamount, California 7/20/2006.

Washington, Chance Suspended aka: Washington, Chanslor indefinitely effective198 Northgate Drive, #132 8/13/2007.Manteca, California

Licensed Vocational Nurse ( susp R)

Caudill, Clair 131772 Suspended51 Sherwood Circle indefinitely effectiveCloverdale, California 8/5/2007.

Contreras, Edward 186745 Suspended5550 Garden Valley Road indefinitely effectiveGarden Valley, California 8/31/2006.

Tollefson, Jamie Frederick 139202 Suspended3075 B Street, #6 indefinitely effectiveSan Diego, California 10/5/2006.

Nurse Aide ( susp R)

Alvarenga, Aura Suspended752 18th Street, B indefinitely effectiveCosta Mesa, California 9/2/2007.

Nurse Aide ( susp R)

Becker, Ana Marie DeGarcia Suspended35 Newell Road, #305 indefinitely effectivePalo Alto, California 8/28/2007.

Espandola, Marisela Suspended1265 Kilson Drive indefinitely effectiveSanta Ana, California 9/3/2007.

Ford, Ellen 628130 Suspended219 River Run Circle, indefinitely effectiveApartment CI 7/19/2007.Sacramento, California

Lopez, Theresa Suspended1402 South Towner Street indefinitely effectiveSanta Ana, California 8/29/2007.

Perez, Esperanza Herrera Suspended336 Hamilton Street indefinitely effectiveCosta Mesa, California 8/29/2007.

Rodriguez, Salvador 6899724 Suspended2570 Newport Boulevard indefinitely effectiveCosta Mesa, California 8/29/2007.

Seldon, Pelma 510208 Suspended5621 El Dorado Avenue, #10 indefinitely effectiveEl Cerrito, California 10/20/2004.

Tellez, Carmela Suspended910 West Street indefinitely effectiveSanta Ana, California 9/3/2007.

Yue, Maria M. Suspended2425 Alvarado Drive indefinitely effectiveSanta Clara, California 8/7/2007.

Registered Nurse ( susp R)

Bateman, Barbara S. 334186 Suspended aka: Koptis, Barbara S. indefinitely effective56495 Lowe Avenue 6/29/2007.Yucca Valley, California

Cahill-Therrien, Mary Eileen 363968 Suspended aka: Therrien, Mary Eileen indefinitely effective2285 Rock Crest Glen 6/25/2007.Escondido, California

Canlas, Adelyn-Grace Lim 982165 Suspended275 S. Arroyo Parkway, #319 indefinitely effectivePasadena, California 7/1/2007.

Gooch, Russell Lee 588556 Suspended2269 Chestnut Street, #154 indefinitely effectiveSan Francisco, California 6/26/2007.

Grimm, Glenn Christian 559879 Suspended273 Plains Court indefinitely effectiveGalt, California 7/18/2007.

Harmon, Janice 443985 Suspended1720 Virginia Way indefinitely effectiveArcata, California 7/13/2007.

Kohl, Catherine S. D. 482586 Suspended12609 Robison Boulevard, indefinitely effective#210 7/12/2007.Poway, California

Please see S&I List, page 10

S&I List (continued)Registered Nurse ( susp R)

La Berrie, Elissa Josephine 327226 Suspended17321 Grandee Place indefinitely effectiveSan Diego, California 7/2/2007.

Lease, Teresa 451178 SuspendedP.O. Box 171 indefinitely effectiveIdyllwild, California 7/2/2007.

Milstone, Craig Stuart 581616 Suspended532 South Lagoon indefinitely effectiveGilbert, Arizona 7/6/2007.

Morales, Carrie A. 529527 Suspended8525 McAlpine Lane indefinitely effectiveRiverside, California 7/2/2007.

Pace, Dawn K. 521546 Suspended2500 Wellerman Way indefinitely effectiveTurlock, California 7/2/2007.

Parmelly, Janet Louise 268148 Suspended aka: Fralick, Janet Louise indefinitely effective4247 Breezy Glen 7/2/2007.Santa Maria, California

Pitifer, Mary Ellen 575468 Suspended aka: Remas, Mary Ellen indefinitely effective517 Empire Court 7/6/2007.Roseville, California

Talbot, Phyllis Meral 563579 Suspended879 Woodlawn Avenue, #B indefinitely effectiveChula Vista, California 7/20/2007.

Respiratory Care Practitioner ( susp S)

Anderson, Darrell Scott 15691 Suspended46865 Skyline Ridge Road indefinitely effectiveCoarsegold, California 2/27/2006.

Antonio, Mauro D. 24702 Suspended7224 Zest Street indefinitely effectiveSan Diego, California 6/4/2007.

Torrevillas, Milvin T. 18632 Suspended707 South Webster Avenue, indefinitely effective#114 6/18/2007.Anaheim, California

Business Owner ( susp T)

Cote, Gary Armand Suspended dba: South Bay Hearing indefinitely effective & Balance 8/13/2007.4510 Campus Avenue, #5San Diego, California

Deguzman, Abraham Calantas Suspended655 Corwin Avenue indefinitely effectiveGlendale, California 8/7/2007.

Johnson, Melvin Van, Sr. Suspended4032 Rosemont Avenue indefinitely effectiveMontrose, California 12/22/2006.

Business Owner ( susp T)

Perea, Gerard P. Suspended dba: DME Billing indefinitely effective Management 8/5/2007.3522 Cotter Rim LaneDiamond Bar, California and13801 Roswell AvenueChino, California

Roy, Robert W. Suspended dba: Western Care indefinitely effective Management Corporation 8/26/2007.8896 BrookdaleMillville, California

Yamalyan, Hagop Suspended and indefinitely effectiveTemple Medical Supply 8/21/2007.2739 W. Temple StreetLos Angeles, California

Employee ( susp T)

Barillas, Cesar A. Suspended8301 S. Vermont Avenue, indefinitely effectiveA, B & C 8/23/2007.Los Angeles, California

Dallarte, Majella Molarte Suspended1630 N. Brighton Street indefinitely effectiveBurbank, California 8/7/2007.

Dioso, Marites R. Suspended626 24th Street, #5 indefinitely effectiveNational City, California 8/7/2007.

Evangelista, Nancy Garcia Suspended1632 1/2 South Lake Street indefinitely effectiveGlendale, California 8/13/2007.

Gonzalez, Jairo Emilio Suspended121 Sinclair Avenue, #240 indefinitely effectiveGlendale, California 8/21/2007.

Gray, Amos Dale Suspended1066 East Poplar indefinitely effectivePorterville, California 8/13/2007.

Guiterrez, Raymond M. Suspended1105 Melia Place indefinitely effectivePlacentia, California 8/23/2007.

Haggood, Elizabeth Marie Suspended26833 Hillview, #2 indefinitely effectiveHighland, California 8/13/2007.

Hudson, Phillip Michael SuspendedP.O. Box 194 indefinitely effectiveTorrance, California 8/29/2007.

Jovovich, Momchilo Suspended2200 Colorado Avenue, #703 indefinitely effectiveSanta Monica, California 8/29/2007.

Please see S&I List, page 11

S&I List (continued)Employee ( susp T)

Layon, Warrie Suspended10336 Beach Boulevard indefinitely effectiveStanton, California 9/2/2007. and26344 Antonio CircleLoma Linda, California

McGuffin, Devere Suspended Warrington, II indefinitely effective401 Meadowgrove Street 8/7/2007.La Canada, California

Medina, Cathy SuspendedP.O. Box 962 indefinitely effectiveChino, California 8/7/2007.

Mendoza, Henry Suspended15724 Marlin Place indefinitely effectiveVan Nuys, California 8/5/2007.

Montoya, Nilda Suspended12960 Dronfield Avenue, indefinitely effective#106 8/5/2007.Sylmar, California

Paz, Elida Suspended12343 Darnell Street indefinitely effectiveGardena Grove, California 9/2/2007.

Roberts, Diana M. Suspended1845 Business Center Drive, indefinitely effective#105 9/2/2007.San Bernardino, California

Sehl, Barbara Yvonne Suspended32 West Johnson Drive indefinitely effectiveSequim, Washington 9/2/2007.

Shorrock, Gerald J. Suspended516 Canal Street, #1 indefinitely effectiveSan Rafael, California 9/2/2007.

Shpolyansky, Eddy Suspended24300 Gilmore Street indefinitely effectiveWest Hills, California 3/5/2007.

Sims, Richard Carlton Suspended#3130668 indefinitely effectiveCorcoran State Prison 8/5/2007.P.O. Box 8800Corcoran, California

Smith, Sybil Agatha Suspended aka: Farrell, Sybil Agatha indefinitely effective2599 W. Lake Van Ness Circle 8/7/2007.Fresno, California

White-Ballard, Carletta Suspended aka: Ballard, Carletta indefinitely effective Percillian 8/26/2007.2521 S. Holmes PlaceOntario, California

In-Home Support Services Provider ( susp U)

Armendariz, Joseph Michael Suspended315 South Garden Avenue, indefinitely effective#139 7/19/2007.Fresno, California

Brown, Glenn Thompson Suspended445 W. Nees, #208 indefinitely effectiveFresno, California 7/19/2007.

Carter-Myles, Latasha Suspended1570 North Delno indefinitely effectiveFresno, California 7/19/2007.

Cooper, Antoinette Lashelle Suspended4342 West Harvard Avenue indefinitely effectiveFresno, California 7/19/2007.

Dansby, Rocheryl Suspended aka: Harmon, Juliette Marie indefinitely effective Green, Sherry 5/20/2007. Wilson, Quinnette Rojers, Jennifer Davis, Sherry Davis, Mary Rogers, Jenifer Shepard, Sherri Woods, Barbara Roberts, Treva Ann927 E. Byrd AvenueFresno, California

Garcia, Generosa Suspended1023 East Nevada Avenue indefinitely effectiveFresno, California 7/19/2007.

Rice, William Cedrick Suspended371 East Jensen indefinitely effectiveFresno, California 7/19/2007.

Thomas, Erycka Resean Suspended108 North Van Ness Avenue indefinitely effectiveFresno, California 7/19/2007.

REINSTATEMENTS:

Physician ( susp A)

Moore, Hezekiah N., M.D. 6/26/20071760 Termino AvenueLong Beach, California and1703 Termino Avenue, #204Long Beach, California

Ragab, Dina T., M.D. 6/20/20073400 Lomita Boulevard, #503Torrance, California

Sumchai, Ahimsa Porter 48983 7/16/2007711 Santa Clara AvenueAlameda, California and236 West Portal Avenue, #563San Francisco, California

Instructions for Manual Replacement Pages Part 1September 2007

Remove and replace: Medi-Cal Program *Manual Organization A-1/A-2 *How to Use This Manual B-1 thru B-6 *

Remove and Replaceat the end of theHow to Use This Manual section: How Are We Doing? 1/2 *

Remove and replace: Manual Ordering C-1/C-2 *

Remove and Replaceat the end of theManual Orderingsection: Subscriber Order Form 1/2 *

Remove and replace: aev trn sofp 1/2 *mcp cohs 7 prov rel 9remit elect corr400 1 thru 8remit elect corr600 9/10

Effective July 1, 2007, the California Department of Health Services (CDHS) has been reorganized into two departments: the California Department of Public Health (CDPH) and the Department of Health Care Services (DHCS). This change will be updated in the Medi-Cal provider manuals on an ongoing basis.

The following updated sections are available at www.medi-cal.ca.gov:

AEVS: Carrier Codes for Other Health Coverage

Medi-Cal Suspended and Ineligible Provider List

* Pages updated due to ongoing provider manual revisions.