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Important Update: One-Year Restriction on Federal Payments to “Prohibited Entities” Under H.R. 1 Section 71113 Ends Effective July 4, 2026
Act
by Jul 4, 2026
Effective date
Jul 4, 2026
Identified
Jun 25, 2026
Summary
Effective July 4, 2026, the one-year federal payment restriction on 'Prohibited Entities' under H.R. 1 Section 71113 expires, allowing these entities to resume submitting Medi-Cal and Family PACT claims for services rendered on or after that date. For the transition period (July 4, 2025–July 3, 2026), DHCS will not penalize providers for non-submission of claims or lack of associated documentation.
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What to do
by Jul 4, 2026 · 7 steps
01Billing team must verify whether your practice is classified as a 'Prohibited Entity' under H.R.
021 Section 71113.
03If classified as such, resume normal claim submission procedures for all covered Medi-Cal and Family PACT services with dates of service on or after July 4, 2026.
04Update billing system rules to remove any blocks or restrictions that were implemented for the July 4, 2025–July 3, 2026 period.
05Ensure all staff are aware that claims for DOS after July 4, 2026 should be submitted without exception.
06Reference the September 17, 2025 DHCS News Alert for clarification on the previous restriction period if needed.
07Contact OFPStakeholder@dhcs.ca.gov for questions about entity classification or claim submission requirements.
Original notice
Important Update: One-Year Restriction on Federal Payments to “Prohibited Entities” Under H.R. 1 Section 71113 Ends Effective July 4, 2026
mcweb.apps.prd.cammis.medi-cal.ca.gov · Always check the source before changing claims.