MedicaidCoverageMedium impact
06-30-2026 H.R. 1 – Federal Payments to Prohibited Entities – Important Update: End of One-Year Restriction on Federal Payments – APL 26-013 IE LA SAC SD
Molina Healthcare·CA·Provider Bulletin
Effective date
Jul 4, 2026
We identified it
Jul 3, 2026
Summary
Effective July 4, 2026, Molina Healthcare of California will resume processing and paying claims from providers previously classified as "Prohibited Entities" under Section 71113 of H.R. 1. Providers affected by the one-year federal payment restriction may resume normal claims and encounter submission for all Medi-Cal covered services. This change applies only to services with dates of service on or after July 4, 2026; prior claims remain subject to earlier guidance.
Action Required
By July 4, 2026: Billing team must resume normal claims submission processes for affected providers. Verify that all claims submitted on or after July 4, 2026 reflect accurate Dates of Service (DOS) to ensure proper processing and payment. Continue following all existing Medi-Cal billing and compliance requirements. Do NOT resubmit claims with DOS between July 4, 2025 – July 3, 2026, as these remain subject to prior restriction guidance. If your practice includes providers previously classified as "Prohibited Entities," coordinate with Provider Relations Representatives in your service county to confirm eligibility and implementation. Failure to use correct DOS may result in claim denials or processing delays.