MedicaidAdministrativeMedium impact
22-075m Enhanced Care Management (ECM) Eligibility Reports Help You Best Serve High-Cost, High-Need Members
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net/Calviva Health will now publish monthly ECM Eligibility Reports through their provider portal to help identify which Medi-Cal members qualify for Enhanced Care Management services. Providers can access these reports to better serve high-cost, high-need members across 12 specific populations of focus including homeless individuals, high utilizers, and those with serious mental illness or substance use disorders.
Action Required
Immediately: Billing and care management teams should begin accessing monthly ECM Eligibility Reports through the Health Net provider portal (Provider Reports > ECM_RPT_BRM_43 report). Review member demographic information and ECM enrollment status to identify qualifying high-cost, high-need Medi-Cal members. Contact CalViva Health at 888-893-1569 for questions about ECM eligibility.