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MedicaidAdministrativeLow impact

20-549 Changes to the Financial Survey and Statement Requirements

Health Net·CA·Provider News
Effective date
Oct 1, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net/CalViva Health has implemented new financial reporting requirements for Risk-Bearing Organizations (RBOs) including Participating Physician Groups (PPGs) with capitated contracts. RBOs must now submit quarterly and annual financial survey reports regardless of member count and comply with updated cash-to-claims ratio and tangible net equity requirements.

Action Required

Action needed
Immediately: Capitated participating physician groups in Fresno, Kings, and Madera counties must ensure compliance with quarterly and annual financial survey reporting requirements to Health Net/CalViva Health. Contact CalViva Health at 1-888-893-1569 to confirm reporting schedules and obtain required forms. Non-compliance may affect contract status and reimbursement.