MedicaidAdministrativeMedium impact
23-970m Reminder: Medi-Cal Overpayment to Providers Must Be Recovered and Returned
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Providers who receive Medi-Cal overpayments must now report and return them within 60 calendar days of identification, along with written notification explaining the reason for the overpayment. This applies to all overpayments made by Health Net on behalf of CalViva Health to participating providers.
Action Required
Immediately: Billing team must establish process to identify and track any Medi-Cal overpayments received from Health Net/CalViva Health. Within 60 days of identifying overpayment: Return funds with copy of Remittance Advice and cover letter explaining reason to Health Net Claims Recovery Team at P.O. Box 396027, San Francisco, CA 94139-6027. Update billing procedures to include overpayment monitoring and reporting workflow.