MedicaidAdministrativeHigh impact
20-040 Submit Contract Status Validation for Hospital Directed Payment Programs
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net requires hospitals and capitated providers in 9 California counties to validate contract status for Medi-Cal encounters from July-December 2018 as part of hospital directed payment programs. Providers must complete specific file formats and return them by strict deadlines to receive supplemental reimbursement.
Action Required
By January 17, 2020: Complete contract status validation files received from Health Net via secure email. Use codes C (Contracted), H (Hospital to hospital), or N (Not contracted) in designated columns. Do not modify file format. Name files using specified convention (PHDP_Contract_YYYYMMDD_[Provider Name] or EPP_Contract_YYYYMMDD_[Provider Name]). Email completed files to both Dianna.Bailey@Centene.com and HNCA_DirectPay@HealthNet.com. Second pass files due by March 6, 2020. Late submissions will not be included in DHCS submissions.