CommercialAdministrativeMedium impact
24-022m Reminder: PPG Financial Survey Reporting, Filing and Oversight Requirements
Health Net·CA·Reimbursement
We identified it
Jun 20, 2026
Summary
Health Net is reminding Participating Physician Groups (PPGs) of their mandatory financial reporting requirements to DMHC and Health Net, including quarterly financial surveys due 45 days after each quarter end and annual surveys due 150 days after fiscal year end. PPGs must also submit corrective action plans when failing to meet specific financial solvency criteria.
Action Required
Finance/billing administrators must ensure quarterly financial surveys are submitted to both DMHC and Health Net Financial Oversight Department by: Q1 - May 15, Q2 - August 15, Q3 - November 15, Q4 - February 15. Annual financial surveys must be submitted by May 31. If any of the six DMHC grading criteria are not met (positive tangible net equity, required TNE levels, positive working capital, 0.75 cash-to-claims ratio, 95% claims timeliness, documented IBNR methodology), submit corrective action plans immediately. Failure to file timely will trigger DMHC follow-up requirements.