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MedicaidAdministrativeMedium impact

25-187 Updated CS and ECM Provider Reference Guides

Health Net·CA·Prior Authorization
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net/CalViva Health has updated their Community Supports (CS) and Enhanced Care Management (ECM) Provider Reference Guides with revisions to provider certification, authorization processes, member eligibility requirements, and capacity reporting sections. Providers need to review the updated guides to ensure compliance with new Medi-Cal contract requirements.

Action Required

Action needed
Immediately: Providers offering Community Supports or Enhanced Care Management services must review the updated CS Reference Guide and ECM Provider Guide available at CalAIM Resources for Providers. Pay special attention to revised sections on provider certification, authorization processes, member eligibility confirmation, and capacity reporting requirements. Contact CalViva Health at 888-893-1569 with questions to ensure compliance with new Medi-Cal contract requirements.