MedicaidAdministrativeMedium impact
22-545m Members Get Better, Simpler Medi-Cal from Mandatory Medi-Cal Enrollment
Health Net·CA·Provider News
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
Effective January 1, 2023, all Medi-Cal beneficiaries in Fresno, Kings, and Madera counties who were previously in fee-for-service (FFS) are now required to enroll in managed care plans like CalViva Health. Providers will see an increase in managed care Medi-Cal patients and a decrease in FFS patients.
Action Required
Immediately: Billing team should verify patient eligibility for all Medi-Cal patients in Fresno, Kings, and Madera counties to confirm managed care plan enrollment rather than assuming FFS coverage. Update patient registration processes to capture managed care plan information. Review provider operations manuals in the Provider Library for updated billing procedures.