Contract and Enrollment Review Division

Return to Audits and Investigations Homepage

Contract and Enrollment Review Division (CERD) conducts state mandated medical and compliance reviews and audits to verify compliance with contractual requirements for the Drug Medi-Cal Organized Delivery Systems and medical, dental and behavioral health managed care plans. Other work performed by CERD includes federally mandated post-service, post-payment behavioral health utilization reviews; provider enrollment onsite reviews of high and moderate risk prospective Medi-Cal providers; onsite reviews for site certification and recertification of county-owned or operated Specialty Mental Health providers; and other requested third-party contract compliance reviews and audits. 

Resources

• Specialty Mental Health Services (SMHS) Provider Certification and Recertification

Reporting Medi-Cal Fraud

Health Care Fraud is a Crime.

• 24-hour hotline (800) 822-6222
• Online web complaint form
• Stop Medi-Cal Fraud

Contact Information

Contract and Enrollment Review Division (CERD)
Department of Health Care Services
1500 Capitol Avenue, MS 2303
PO Box 997413
Sacramento, CA 95899-7413

Phone: (916) 440-7460