MedicaidAdministrativeMedium impact
22-1094 Facility Site Review and Medical Record Review Changes
Health Net·CA · Family Medicine, Internal Medicine, Pediatrics +1 more·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net updated facility site review (FSR) and medical record review (MRR) standards for Medi-Cal providers, expanding criteria for initial health assessments, screening requirements, and changing corrective action plan timelines. Providers must now submit corrective action plans within 30 days and close non-critical CAPs within 90 days.
Action Required
Immediately: Review updated FSR and MRR criteria in the Provider Library under Quality Improvement section. Ensure compliance with new requirements including Initial Health Assessment within 120 days of member enrollment, blood lead screening, autism disorder screening, and maternal depression screening by PCPs. If cited for deficiencies, submit corrective action plans to Health Net within 30 calendar days and close non-critical CAPs within 90 calendar days. Contact Health Net Provider Services at 800-675-6110 with questions within 60 days.