MedicaidReimbursementHigh impact
26-933 DHCS Confirms Expiration of the Temporary Federal Payment Restriction Under H.R. 1
Health Net·CA·Reimbursement
Effective date
Jul 4, 2026
We identified it
Aug 12, 2026
Summary
As of July 4, 2026, the temporary federal payment restriction for certain Medi-Cal providers classified as prohibited entities under H.R. 1 has expired. Affected providers may now resume submitting claims for covered Medi-Cal services with dates of service on or after July 4, 2026, and claims will be processed through standard adjudication procedures. This supersedes previous guidance from provider update 25-1073.
Action Required
By July 4, 2026: Billing team must resume normal claims submission for all Medi-Cal services provided on or after this date to affected providers. Update internal tracking systems or holds to reflect that the payment restriction has been lifted. Remove any manual claim holds or blocks previously implemented for prohibited entities. Verify with provider compliance or legal team if your practice was classified as a prohibited entity under H.R. 1 to determine applicability. Contact CalViva Health at 888-893-1569 (or 844-966-0298 for Behavioral Health) if uncertain about your provider status. Failure to resume billing after July 4, 2026 may result in delayed reimbursement for eligible services.