The Department of Health Care Services’ (DHCS) Personal Injury (PI) Program is required by federal and state law to recover funds for Medi-Cal paid services related to a liable third party action when a member receives a settlement, judgment, or award. The information below will help you submit proper notification to DHCS, but you must complete the appropriate form in its entirety and review for accuracy. For security purposes, we do not accept digital media.​​ 

报告新案例（步骤 1）：​​ 

每起伤害请提交一份新案件通知，因为多次提交可能会导致处理延迟。 新案件通知必须包含以下内容以满足 W&I 法典第 14124.73(c) 条的报告要求：​​ 

1.     Date of the Medi-Cal member’s injury.​​ 

2.     Member’s Medi-Cal ID number as listed on their Benefits Identification Card (BIC), or Social Security Number.​​ 

3.责任第三者或保险人的联络方式。​​ 

4. 索赔管理员的联系信息，包括其索赔编号。​​ 

5. 代表责任第三人或保险人的任何辩护律师的联系方式。​​ 

Allow 30 days for DHCS to send a letter confirming receipt of the notification. If the injured party is Medi-Cal eligible, the letter will detail DHCS’ recovery rights and lien process.​​ 

The Medi-Cal ID number can be found on the member’s Medi-Cal Benefits Identification Card (BIC) shown below. The member’s Medi-Cal ID number is comprised of the first 9 characters, beginning with “9,” followed by 7 additional numbers, and ending with a letter. If you do not have the member’s Medi-Cal ID number, you can enter the member’s Social Security Number.​​ 

案例更新（第 2 步）：​​                                                                                   

• Provide a case update when the member has completed treatment with a Medi-Cal provider or after the settlement has occurred. DHCS will order and review the payment records, then send the Medi-Cal lien.​​ 
• 如果您有新的信息需要报告或有现有案件需要提供的文件，请提供案件更新信息。 出于安全目的，我们不接受数字媒体。​​