MedicaidAdministrativeMedium impact
26-147 Updated CS and ECM Provider Reference Guides Now Available
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net updated Community Supports (CS) and Enhanced Care Management (ECM) provider reference guides to align with latest Medi-Cal requirements. Multiple sections were revised covering eligibility verification, authorization processes, claims, and provider certification requirements.
Action Required
Immediately: Review updated CS and ECM provider reference guides at CalAIM Resources for Providers website. Billing team should update workflows for member eligibility verification (Section 8.1), authorization review processes (Section 8.2.2), claims submission procedures (Section 9.1.1), and payment processes (Section 9.4). ECM providers must review updated certification requirements and member assignment processes.