MedicaidAdministrativeMedium impact
24-218 Ensure Effective Post-Discharge Care and Minimize Readmissions
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
CalViva Health has launched a new Transitional Care Services (TCS) program requiring proactive follow-up appointments within seven days post-hospitalization to reduce readmissions. The insurance company will reach out to providers to verify that post-discharge services and follow-up meetings are organized or conducted within this timeframe.
Action Required
Immediately: All providers must ensure post-discharge follow-up appointments are scheduled and conducted within seven days after hospital discharge. Document all follow-up services provided. Expect contact from CalViva Health (888-893-1569) to verify follow-up care coordination. Refer members to TCS program by calling 866-801-6294 when appropriate.