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HomeHealth and Safety CodeDiv. 106Pt. 1Ch. 1§ 123114 Healthcare Provider Form Fees

§ 123114 Healthcare Provider Form Fees

Health and Safety Code·California
AI Summary·Official Text·Key Terms·Related Statutes·References
AI SummaryVerified

§ 123114 Healthcare Provider Form Fees

Key Takeaways

  • •Doctors and hospitals can't charge you money just for filling out forms that help you get government help, like food stamps or disability benefits.
  • •If your doctor has the info needed to answer medical questions on the form, they must fill it out. If they don’t have the info, they can tell you if you need a check-up to get it.
  • •If you need a check-up for the form, the doctor must fill out the parts they can answer after the check-up.
  • •This rule covers many government help programs, like Medi-Cal, food stamps (CalFresh), and disability benefits.

Example

You apply for disability benefits and need your doctor to fill out a form about your health.

Your doctor can’t charge you just for filling out the form. If they already know about your condition, they must fill it out. If they need to check you first, they’ll do that and then fill out what they can.

AI-generated — May contain errors. Not legal advice. Always verify source.

Official Source
View on CA.gov

§ 123114 Healthcare Provider Form Fees

(a) A health care provider shall not charge a fee to a patient for filling out forms or providing information responsive to forms that support a claim or appeal regarding eligibility for a public benefit program. (b) A health care provider shall provide information responsive to those portions of the form for which the health care provider has the information necessary to provide a medical opinion. If the health care provider does not have the information necessary to provide a medical opinion, the health care provider may inform the patient if an examination is necessary to obtain the information. (c) If a health care provider conducts an examination pursuant to subdivision (b), the health care provider shall provide information responsive to those portions of the form for which the health care provider has a medical opinion. (d) For the purposes of this section, a public benefit program includes the Medi-Cal program, the In-Home Supportive Services Program, the California Work Opportunity and Responsibility to Kids (CalWORKs) program, Social Security Disability Insurance benefits, Supplemental Security Income/State Supplementary Program for the Aged, Blind and Disabled (SSI/SSP) benefits, federal veterans service-connected compensation and nonservice connected pension disability benefits, discharge of a federal student loan based on total and permanent disability, CalFresh, the Cash Assistance Program for Aged, Blind, and Disabled Legal Immigrants, and a government-funded housing subsidy or tenant-based housing assistance program. (e) Notwithstanding any other law, a health care provider may honor a request to disclose a patient record or complete a public benefit form that contains the written or electronic signature of the patient or the patient’s personal representative. (Added by Stats. 2020, Ch. 101, Sec. 3. (AB 2520) Effective January 1, 2021.)

Last verified: January 23, 2026

Key Terms

health care providerpublic benefit programMedi-CalCalWORKsSSI/SSP

Related Statutes

  • § 101530 Sonoma County Dental Funding
  • § 101960 Los Angeles Healthcare Crisis
  • § 123105 Healthcare Provider Definitions
  • § 123120 Patient Rights Enforcement Actions
  • § 124420 Third-Party Reimbursement Requirement

References

  • Official text at leginfo.legislature.ca.gov
  • California Legislature. Health and Safety Code. Section 123114.
View Official Source