Medicare AdvantageAdministrativeMedium impact
First Quarter 2026
Molina Healthcare·UT·Provider Bulletin
We identified it
Aug 5, 2026
Summary
Molina Healthcare of Utah Q1 2026 newsletter updates providers on Medicare Stars resources, quality performance metrics (HEDIS and CAHPS), and establishes mandatory provider data validation requirements. Providers must validate all practice information through CAQH every 90 days or face removal from the provider directory, and must notify Molina of any changes within 30 days.
Action Required
REQUIREMENTS:
- Within 90 days (by April 2026): All providers must log into CAQH portal and validate accuracy of practice information including name, address(es), specialty(ies), phone/fax/email, NPI, Tax ID, and new patient status for PCPs. Delegated providers must submit complete rosters to Molina. Failure to validate will result in removal from the Molina Provider Directory.
- Immediately and ongoing: Establish process for front desk/administrative staff to notify Molina of ANY changes (location, hours, phone, fax, email, office opening/closure, provider additions, name changes, specialty changes, new patient status) at least 30 calendar days in advance. Document all notifications.
- By end of Q1 2026: Billing and clinical staff should review HEDIS and CAHPS tip sheets available on Availity Essentials portal to understand quality measures that affect reimbursement and Star ratings.
- Ongoing: Encourage providers to participate in mental health screening and documentation to support quality metrics.