MedicaidAdministrativeMedium impact
20-286 Stay Current with MCAS Updates to Be Sure You Meet Performance Levels
Health Net·CA·Prior Authorization
Effective date
Jan 1, 2020
We identified it
Jun 20, 2026
Summary
Health Net updated the Managed Care Accountability Set (MCAS) quality measures for 2020 measurement year, removing some measures like Annual Monitoring for Patients on Persistent Medications and adding new behavioral health monitoring requirements. Providers must meet national Medicaid 50th percentile performance levels and ensure timely claims submissions with proper coding to maintain performance rates.
Action Required
Immediately: Review and update billing practices to align with 2020 MCAS requirements. Quality team should access HEDIS 2020 Volume 2 Technical Specifications from NCQA website and review tip sheets at Health Net provider portal. Ensure claims submissions include proper ICD-10 codes Z71.3 for nutrition counseling, Z02.5 and Z71.82 for physical activity counseling. Contact Quality Improvement Department at cqi_dsm@healthnet.com for coding guidance. Failure to meet performance levels may impact provider ratings.