MedicaidReimbursementMedium impact
20-554 Earn Incentives through the Prop 56 VBP Program
Health Net·CA · Family Medicine, Internal Medicine, Pediatrics +2 more·Pharmacy
Effective date
Jul 1, 2019
We identified it
Jun 20, 2026
Summary
Health Net California's Prop 56 Value-Based Payment Program offers supplemental payments for qualifying services in prenatal/postpartum care, early childhood, chronic disease management, and behavioral health integration for Medi-Cal members. Providers must submit W-9 forms with individual NPIs to receive payments and ensure claims include proper provider identification.
Action Required
Immediately: All providers must submit completed W-9 forms with individual (Type 1) NPI to HNCA_W9_Submissions@CENTENE.COM with 'Prop 56 W9' in subject line or fax to 1-833-794-0423. Billing team must ensure all qualifying claims include individual NPI in rendering, ordering, prescribing, or billing provider fields. Review attachment for complete list of qualifying CPT and ICD-10 codes for VBP measures. Claims without individual NPIs will not receive supplemental payments.