MedicaidReimbursementMedium impact
25-837 Correction for Provider Update 25-727
Health Net·CA·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Health Net/CalViva Health clarified that starting January 1, 2026, insurance plans that fail to automatically pay required interest on late-paid claims must also pay a penalty fee equal to the greater of $15 or 10% of the accrued interest. This penalty only applies when the interest payment is omitted, not simply for late claim payment.
Action Required
By January 1, 2026: Billing team should monitor claim payments more closely to identify when interest payments are missing from late-paid claims. Document instances where required interest is not paid automatically and follow up with CalViva Health at 888-893-1569 to request both the missing interest and the additional penalty fee ($15 or 10% of accrued interest, whichever is greater).