UNAUTHORIZED ACCESS TO ANY STATE OF CALIFORNIA COMPUTING SYSTEM CONTAINING US GOVERNMENT OR STATE OF CALIFORNIA INFORMATION IS A CRIMINAL VIOLATION OF THE PENAL CODE SECTION 502 AND/OR APPLICABLE FEDERAL LAW AND IS SUBJECT TO CIVIL AND CRIMINAL SANCTIONS. Whoever knowingly or intentionally accesses a computing system without authorization or exceeding authorized access, and by means of such conduct, obtains, alters, damages, destroys, or discloses information, or prevents authorize users of any data or computing resource owned by or operated for the State of California shall be subject to disciplinary action, prosecution or both. Use in a manner other than as intended by the State of California may result in the forfeiture of access privileges. All computing system activities may be recorded and monitored. Individuals using these systems expressly consent to such monitoring and shall have no expectation of privacy in their use. Evidence of possible misconduct or abuse may be provided to appropriate officials and/or law enforcement. No warranty is made for the computing resources that are subject to this policy. Additionally, the State of California takes no responsibility of damages for the intentional misuse of these resources by any party.

All information requested on the Application, the disclosure statement, and the provider agreement is mandatory. This information is required by the California Department of Health Care Services and any other California State Departments that are delegated responsibility to administer the Medi-Cal program, by the authority of the Welfare and Institutions Code, Sections 14043 - 14043.75, the California Code of Regulations, Title 22, Sections 51000 - 51451 and the Code of Federal Regulations, Title 42, Part 455. The consequences of not supplying the mandatory information requested are denial of enrollment as a Medi-Cal provider or denial of continued enrollment as a provider and deactivation of all provider numbers used by the provider to obtain reimbursement from the Medi-Cal program. Some or all of this information may also be provided to the California State Controller's Office, the California Department of Justice, the California Department of Consumer Affairs, the California Department of Corporations, the California Franchise Tax Board or other California state or local agencies as appropriate, fiscal intermediaries, managed care plans, the Federal Bureau of Investigation, the Internal Revenue Service, Medicare Fiscal Intermediaries, Centers for Medicare and Medicaid Services, Office of the Inspector General, Medicaid, or as required or permitted by law. For more information or access to records containing your personal information maintained by this agency, contact the Provider Enrollment Division at (916) 323-1945 or contact Denti-Cal at (800) 423-0507.