MedicaidPrior AuthMedium impact
25-1387m 2026 CalAIM Program Updates: What Medi-Cal Providers Need to Know
Health Net·CA · Family Medicine, Internal Medicine, Pediatrics +1 more·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
CalAIM Community Supports programs are implementing significant changes to authorization guides, forms, and billing processes for Medi-Cal providers starting January 1, 2026. Key changes include removal of certain asthma services, new housing deposit limits, updated eligibility criteria for housing navigation services, and billing changes for Personal Care and Homemaker Services requiring 15-minute increments using the 'Rule of Eights.'
Action Required
By January 1, 2026: Billing teams must access the CalAIM Resources for Provider page to download updated authorization guides and forms for all Community Supports programs. Update billing system to process Personal Care and Homemaker Services in 15-minute increments following the 'Rule of Eights.' Providers must update workflows to use new Asthma Preventive Services Authorization Forms and revised Housing Navigation authorization forms with updated eligibility criteria.