MedicaidAdministrativeHigh impact
20-041 Submit Contract Status Validation for Hospital Directed Payment Programs
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net requires participating hospitals and physician groups in Fresno, Kings, and Madera counties to validate their contract status for Medi-Cal members by completing and returning specific encounter files. This validation is required for the Designated Public Hospital Enhanced Payment Program and Private Hospital Direct Payment Program supplemental reimbursements.
Action Required
By January 17, 2020: Complete contract status validation files received from Health Net via secure email. Do not modify file format or data. Fill in 'Plan_Contract_Status' column (for capitated providers) or 'Hospital_Contract_Status' column (for hospitals) with codes: C (Contracted), H (Hospital to hospital), or N (Not contracted). Use proper file naming convention and email completed files to both Dianna.Bailey@Centene.com and HNCA_DirectPay@HealthNet.com. Second/final pass files must be submitted by March 6, 2020. Late submissions will not be included in DHCS submissions.