All Insurance Policy Changes (Page 704)

Continuing from page 703. Showing older policy changes tracked across all payers. Use the filters in the related-hubs section below to narrow by provider, state, or specialty.

Medium impact
26-723 Updates to Quality Incentive Pool and Directed Payment Programs
Health Net·Effective Jun 1, 2026
Starting June 2026, Health Net and Community Health Plan of Imperial Valley will collect and report Quality Incentive Pool (QIP) performance data on behalf of providers, replacing the current system where hospitals calculate and submit their own QIP rates. New dedicated contact emails have been established for each directed payment program to improve support.
Medium impact
26-715 New Online Provider Onboarding Training Attestation for Medi-Cal
Health Net·Effective Aug 1, 2026
Health Net requires Medi-Cal providers to submit online attestations for new provider onboarding training starting August 1, 2026. Paper forms will no longer be accepted, and the attestation must be completed within 30 days of contract activation to avoid delays.
Medium impact
26-716 New Online Provider Onboarding Training Attestation for Medi-Cal
Health Net·Effective Aug 1, 2026
Health Net now requires online attestation forms for all new Medi-Cal provider onboarding training, effective August 1, 2026. Paper forms will no longer be accepted, and the attestation must be completed within 30 days of contract activation to avoid delays.
Medium impact
26-717 New Online Provider Onboarding Training Attestation for Medi-Cal
Health Net·Effective Aug 1, 2026
Health Net now requires online attestation forms for all new Medi-Cal provider onboarding training starting August 1, 2026. Paper forms will no longer be accepted, and the attestation must be submitted for each provider who completes onboarding training to ensure timely contract activation.
Medium impact
26-710m Updates to Clinical Policies – April 2026
Health Net·Effective Apr 1, 2026
HealthNet California has issued updates to clinical policies effective April 2026, including retired policies. The full details are available in a downloadable PDF document that providers need to review for specific changes affecting their practice.
Medium impact
26-711m Updates to Clinical Policies – April 2026
Health Net·Effective Apr 1, 2026
HealthNet California has issued clinical policy updates effective April 2026, which may include changes to coverage, prior authorization requirements, or billing procedures. The policy document contains retired policies and updates that could affect billing and reimbursement for Medi-Cal providers in Imperial County.
Medium impact
26-712m Updates to Clinical Policies – April 2026
Health Net·Effective Apr 1, 2026
Health Net California has released policy updates effective April 2026, including retired policies that will affect billing and coverage. The full details are contained in a PDF document that requires download and review to determine specific changes to clinical policies.
Medium impact
26-713m Updates to Medicare Clinical Policies – April 2026
Health Net·Identified Jun 20, 2026
HealthNet California has published updates to Medicare clinical policies effective April 2026. The policy document requires download as a PDF to review specific changes to clinical practice guidelines that affect physicians, hospitals, and ancillary providers.
Medium impact
26-722 Updates to Quality Incentive Pool and Directed Payment Programs
Health Net·Effective Jun 1, 2026
Starting June 2026, Health Net and CalViva Health will collect and report Quality Incentive Pool (QIP) performance data on behalf of providers, replacing the current system where hospitals calculate and submit their own QIP performance rates. New dedicated contact emails have been established for various directed payment programs to streamline support and guidance.
Medium impact
26-743 State of Emergency: Chemical Incident in Orange County
Health Net·Effective May 23, 2026
Health Net has implemented emergency policy changes for Orange County providers affected by the chemical incident declared as a state of emergency on May 23, 2026. The policy allows for expedited prior authorizations, extended claim filing deadlines, out-of-network service approvals, and emergency prescription refills for affected members.
Medium impact
26-719m Capitation Payments for Newborns: No Separate Payment Until Month 3
Health Net·Identified Jun 20, 2026
Providers must not request separate capitation payments for newborns during the first 2 months when the mother is enrolled in Medi-Cal. Newborns are covered under the mother's plan during birth month and following month, with separate payments beginning in month 3 using the newborn's individual CIN.
Medium impact
26-718m Capitation Payments for Newborns: No Separate Payment Until Month 3
Health Net·Identified Jun 20, 2026
For Medi-Cal newborns, providers must not request separate capitation payments during the first 2 months of life - newborns are covered under the mother's plan during this period. Starting in month 3, use the newborn's individual Client Index Number (CIN) for separate capitation payments.
Medium impact
26-720m Capitation Payments for Newborns: No Separate Payment Until Month 3
Health Net·Identified Jun 20, 2026
For Medi-Cal newborns in Imperial County, providers must not request separate capitation payments during the first 2 months after birth - newborns are covered under the mother's plan during this period. Starting in month 3, use the newborn's individual Client Index Number (CIN) for separate capitation payments.
Medium impact
26-693 New Limits on Location Tracking Near Healthcare Facilities
Health Net·Effective Jan 1, 2026
California has implemented new restrictions on location-based tracking technologies like geofencing near healthcare facilities to protect patient privacy. Healthcare providers must review and ensure their vendors and third-party technologies comply with these restrictions or face privacy and compliance risks.
Medium impact
26-694 New Limits on Location Tracking Near Healthcare Facilities
Health Net·Effective Jan 1, 2026
California has implemented new restrictions on location tracking and geofencing technologies near healthcare facilities, effective January 1, 2026. Healthcare providers must review and ensure their vendors and third-party technology partners comply with these privacy requirements to avoid compliance risks.
Medium impact
26-691 New Limits on Location Tracking Near Healthcare Facilities
Health Net·Effective Jan 1, 2026
California has implemented new restrictions on location tracking and geofencing technologies near healthcare facilities to protect patient privacy. Healthcare providers must review and ensure their vendors and third-party technology partners comply with these restrictions or face privacy and compliance risks.
High impact
26-742 Provider Communications Posted Online and Operations Manual Updates for May 2026
Health Net·Effective May 12, 2026
Multiple Medi-Cal policy updates for May 2026 including a critical prior authorization timeline change from 7 calendar days to 5 business days or 7 calendar days (whichever is less), new capitation payment procedures for newborns, and updated youth trauma screening requirements affecting claims reimbursement.
High impact
26-741 Provider Communications Posted Online and Operations Manual Updates for May 2026
Health Net·Effective May 12, 2026
Medi-Cal updated prior authorization timelines from seven calendar days to five business days or seven calendar days (whichever is less), effective May 12, 2026. Additional updates include youth trauma screening requirements affecting claims reimbursement and newborn capitation payment procedures.
Medium impact
26-739 Provider Communications Posted Online and Operations Manual Updates for May 2026
Health Net·Effective May 12, 2026
Health Net posted May 2026 provider communications and operations manual updates, including key changes to Medi-Cal prior authorization timelines (now 5 business days or 7 calendar days, whichever is less), updated youth trauma screening requirements affecting reimbursement, and new member ID card designs that must be accepted alongside existing cards.
Medium impact
26-746 Action Required: Update and Confirm Your Provider Directory Information to Avoid Removal
Health Net·Identified Jun 20, 2026
CalViva Health requires all providers to regularly update and validate their directory information using approved submission methods to comply with California regulations. Providers with inaccurate or unconfirmed information may be removed from the provider directory.
Medium impact
26-747 Action Required: Update and Confirm Your Provider Directory Information to Avoid Removal
Health Net·Identified Jun 20, 2026
Health Net/Community Health Plan of Imperial Valley requires all providers to update and confirm their directory information using approved submission methods to comply with California regulations. Providers who fail to maintain accurate information may be removed from the provider directory.
Medium impact
26-745 Action Required: Update and Confirm Your Provider Directory Information to Avoid Removal
Health Net·Identified Jun 20, 2026
Health Net requires all providers to regularly update and confirm their provider directory information using one of three approved methods (Symphony Provider Directory, Availity Provider Data Management, or Online Demographic Update Form). Providers who fail to maintain accurate information or respond to validation requests may be removed from the provider directory.
Medium impact
26-725 Expanded DMHC Notification Requirements for PPG and Hospital Network Terminations
Health Net·Effective Jan 1, 2026
Health Net CalViva Health has expanded notification requirements for network terminations, now requiring Participating Provider Groups (PPGs) and hospitals to notify their Provider Network Management contact immediately when any type of termination is planned, including partial terminations, non-renewals, and service line losses. Hospital terminations require DMHC approval before removal from network, and late submissions will result in corrective action affecting delegation status.
Medium impact
26-726 Expanded DMHC Notification Requirements for PPG and Hospital Network Terminations
Health Net·Effective Jan 1, 2026
Health Net California has expanded notification requirements for Participating Provider Groups (PPGs) and hospitals, requiring immediate notification when any type of network termination is planned or anticipated. This includes new termination types like partial service line loss, non-renewals, and constructive terminations, with compliance required by January 1, 2026.
Medium impact
26-727 Expanded DMHC Notification Requirements for PPG and Hospital Network Terminations
Health Net·Effective Jan 1, 2026
Health Net California has expanded notification requirements for Participating Provider Groups (PPGs) and hospitals, requiring immediate notification to Health Net when any network termination is planned or anticipated, including partial, non-renewal, constructive, novation and assignment-related terminations. Late or incomplete submissions will result in corrective action and impact delegation status.

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Archive by year

2023 2024 2025 2026

26-723 Updates to Quality Incentive Pool and Directed Payment Programs

26-715 New Online Provider Onboarding Training Attestation for Medi-Cal

26-716 New Online Provider Onboarding Training Attestation for Medi-Cal

26-717 New Online Provider Onboarding Training Attestation for Medi-Cal

26-710m Updates to Clinical Policies – April 2026

26-711m Updates to Clinical Policies – April 2026

26-712m Updates to Clinical Policies – April 2026

26-713m Updates to Medicare Clinical Policies – April 2026

26-722 Updates to Quality Incentive Pool and Directed Payment Programs

26-743 State of Emergency: Chemical Incident in Orange County

26-719m Capitation Payments for Newborns: No Separate Payment Until Month 3

26-718m Capitation Payments for Newborns: No Separate Payment Until Month 3

26-720m Capitation Payments for Newborns: No Separate Payment Until Month 3

26-693 New Limits on Location Tracking Near Healthcare Facilities

26-694 New Limits on Location Tracking Near Healthcare Facilities

26-691 New Limits on Location Tracking Near Healthcare Facilities

26-742 Provider Communications Posted Online and Operations Manual Updates for May 2026

26-741 Provider Communications Posted Online and Operations Manual Updates for May 2026

26-739 Provider Communications Posted Online and Operations Manual Updates for May 2026

26-746 Action Required: Update and Confirm Your Provider Directory Information to Avoid Removal

26-747 Action Required: Update and Confirm Your Provider Directory Information to Avoid Removal

26-745 Action Required: Update and Confirm Your Provider Directory Information to Avoid Removal

26-725 Expanded DMHC Notification Requirements for PPG and Hospital Network Terminations

26-726 Expanded DMHC Notification Requirements for PPG and Hospital Network Terminations

26-727 Expanded DMHC Notification Requirements for PPG and Hospital Network Terminations