MedicaidAdministrativeMedium impact
25-785 New Updates to CS and ECM Provider Reference Guides
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net/CalViva Health has updated Community Supports (CS) and Enhanced Care Management (ECM) provider reference guides to reflect recent changes from the Department of Health Care Services. Key sections have been revised including provider certification, authorization portals, eligibility criteria, and care team staffing requirements.
Action Required
Immediately: Providers delivering Community Supports or Enhanced Care Management services must review the updated reference guides at CalAIM Resources for Providers. Focus on revised sections including provider certification applications, authorization portal procedures, eligibility criteria, and care team staffing requirements. Contact CalViva Health at 888-893-1569 with questions. Failure to follow updated guidelines may impact service authorization and reimbursement.