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26-1008a Prepare for Unsatisfactory Immigration Status Member Transitions to Medi-Cal FFS
Act
by Jan 1, 2027
Effective date
Jan 1, 2027
Identified
Aug 25, 2026
Summary
Effective January 1, 2027, Medi-Cal members with Unsatisfactory Immigration Status (UIS) will transition from managed care plans to Medi-Cal Fee-for-Service (FFS). Providers must be enrolled in Medi-Cal FFS by the deadline to continue treating these members and receive reimbursement. Billing processes, claims submission, and authorization requirements will shift from managed care to FFS workflows.
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What to do
by Jan 1, 2027 · 8 steps
01Billing team must verify current Medi-Cal FFS enrollment status for your practice.
02If not enrolled, submit application through the PAVE (Provider Application and Validation for Enrollment) system immediately to meet the deadline.
03Update billing system configuration to process UIS member claims through Medi-Cal FFS rather than managed care plans.
04Modify prior authorization workflows to comply with Medi-Cal FFS requirements instead of managed care plan requirements.
05Train billing and front desk staff on new eligibility verification procedures and FFS claims submission processes.
06Review and update encounter forms to ensure providers document required information for FFS billing.
07Failure to complete FFS enrollment by January 1, 2027 will result in loss of reimbursement for services provided to UIS members after the transition date.
08Continue verifying member eligibility and enrollment status prior to rendering services to identify affected UIS members early.
Original notice
26-1008a Prepare for Unsatisfactory Immigration Status Member Transitions to Medi-Cal FFS
providerlibrary.healthnetcalifornia.com · Always check the source before changing claims.
Related changes
See all Health Net changes →26-1008 Prepare for Unsatisfactory Immigration Status Member Transitions to Medi-Cal FFSHighEffective Jan 1, 2027 · Prior Authorization26-1009 Prepare for Unsatisfactory Immigration Status Member Transitions to Medi-Cal FFSHighEffective Jan 1, 2027 · Prior Authorization26-1010 Prepare for Unsatisfactory Immigration Status Member Transitions to Medi-Cal FFSHighEffective Jan 1, 2027 · Prior AuthorizationBrowse every Health Net change in the policy list