MedicaidAdministrativeMedium impact
25-188 Updated CS and ECM Provider Reference Guides
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net updated Community Supports and Enhanced Care Management provider reference guides to align with Department of Health Care Services requirements. Multiple sections were revised including provider certification, authorization processes, member eligibility, and capacity reporting requirements.
Action Required
Immediately: All Community Supports and Enhanced Care Management providers must review the updated CS Reference Guide and ECM Provider Guide available at CalAIM Resources for Providers. Focus on revised sections including provider certification applications, authorization guides, member eligibility confirmation processes, and capacity reporting requirements. Contact Community Health Plan of Imperial Valley at 833-236-4141 with questions. Ensure compliance with updated administrative and authorization procedures.