MedicaidAdministrativeMedium impact
24-219 Ensure Effective Post-Discharge Care and Minimize Readmissions
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Community Health Plan of Imperial Valley launched a new Transitional Care Services (TCS) program requiring proactive follow-up appointments within 7 days post-hospitalization to reduce readmissions. The insurer will actively reach out to verify that post-discharge services and follow-up meetings are scheduled or completed within this timeframe.
Action Required
Immediately: Ensure all hospitalized patients have follow-up appointments scheduled within 7 days of discharge. Billing team should be prepared to receive verification calls from Community Health Plan at 866-801-6294 regarding post-discharge appointment scheduling. Document all scheduled follow-ups in patient records to confirm compliance with TCS program requirements.