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MedicaidReimbursementMedium impact

22-668 Alert! Proposition 56 Value-Based Payment Program Has Ended

Health Net·CA · Family Medicine, Internal Medicine, Pediatrics +2 more·Prior Authorization
Effective date
Jun 30, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net's Proposition 56 Value-Based Payment (VBP) program has ended effective June 30, 2022. Services performed after this date are no longer eligible for enhanced VBP payments, though regular Medi-Cal reimbursement continues.

Action Required

Action needed
Immediately: Billing team should stop expecting enhanced VBP payments for services performed after June 30, 2022. Review any outstanding claims for prenatal/postpartum care, early childhood preventive care, chronic disease management, and behavioral care services to ensure VBP payments are only expected for dates of service through June 30, 2022. Continue submitting regular Medi-Cal claims as normal.