MedicaidAdministrativeMedium impact
20-736 Get Ready for Changes to the Medi-Cal Subnetwork Certification Assessment and Attend Upcoming Webinar
Health Net·CA·Prior Authorization
Effective date
Aug 1, 2020
We identified it
Jun 20, 2026
Summary
Health Net is implementing annual network adequacy assessments for Participating Physician Groups (PPGs) in Medi-Cal subnetworks in Fresno, Kings and Madera counties. PPGs must demonstrate adequate provider networks and may face corrective action plans or network participation impacts if standards are not met.
Action Required
By March 2021: PPGs must ensure provider rosters submitted to Health Net contain correct adult and pediatric provider types and patient age ranges. Review network adequacy for provider-to-member ratios, mandatory provider types (FQHC, RHC, IHF), time and distance standards, and timely access requirements. Register for the September 30, 2020 webinar to learn compliance requirements. PPGs failing to meet standards will be subject to corrective action plans.