MedicaidAdministrativeMedium impact
25-161m Support Members Enrolled in ECM Prior to Release from Correctional Facilities
Health Net·CA · Psychiatry, Family Medicine, Internal Medicine·Prior Authorization
Effective date
Oct 1, 2024
We identified it
Jun 20, 2026
Summary
New policy establishes Enhanced Care Management (ECM) requirements for justice-involved members transitioning from correctional facilities to community care. ECM providers must create comprehensive reentry care plans, conduct warm handoffs, and meet specific timeline requirements for pre and post-release coordination.
Action Required
Immediately: ECM providers must monitor sFTP folders daily for member assignments and establish Justice Involved Initiative workflows. Implement reentry care plan documentation requirements including whole-person assessments by licensed professionals (RN or LCSW). Schedule warm handoff meetings within required timelines and ensure follow-up appointments within 1-2 business days of release and again within one week. Contact CalViva Health Justice Involved Liaison at 800-526-1898 for assistance. Bill pre-release services to DHCS fee-for-service and post-release services to the Plan starting from release date.