MedicaidAdministrativeMedium impact
25-521 Help Ensure Medi-Cal Members Get the ECM and CS Services They Need
Health Net·CA·Prior Authorization
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Summary
New closed-loop referral requirements for Medi-Cal Enhanced Care Management (ECM) and Community Supports (CS) services become effective July 1, 2025. Providers must use electronic communication methods, submit monthly data files by the 5th of each month via SFTP, and use specific platforms (Provider Portal or Findhelp) for referrals.
Action Required
By July 1, 2025: Billing and clinical teams must implement new referral tracking procedures for Medi-Cal ECM and CS services. Update workflows to use Provider Portal for ECM referrals and Findhelp platform for CS referrals. Establish monthly data submission process via SFTP by the 5th of each month. Train staff on electronic communication requirements and discontinue fax-only communication unless mutually agreed upon. Set up tracking to ensure referral closure within 90 days of member assignment.