MedicaidAdministrativeMedium impact
25-165 Get Ready: The Medi-Cal Subnetwork Certification Assessment Starts in April
Health Net·CA·Prior Authorization
Effective date
Apr 1, 2025
We identified it
Jun 20, 2026
Summary
Health Net will conduct Medi-Cal Subnetwork Certification Assessments for participating physician groups from April through September 2025 to evaluate network adequacy including provider ratios, time/distance standards, and timely access requirements. PPGs that fail to meet standards face corrective action plans and potential network participation eligibility issues.
Action Required
Before April 2025: Participating Physician Groups must review and verify provider roster information is accurate including correct adult/pediatric provider types and patient age ranges. Register for webinars on March 19 or March 26, 2025 to learn assessment requirements. Review provider update 25-159m for access to care standards. Ensure network meets provider-to-member ratios, time/distance standards, and appointment access requirements. Failure to meet standards will result in corrective action plans and potential loss of network participation.