MedicaidAdministrativeLow impact
26-986 Strengthening PPG Performance Standards and Oversight
Health Net·CA·Provider News
We identified it
Sep 3, 2026
Summary
CalViva Health has updated its Participating Physician Group (PPG) performance management processes, implementing a formal Corrective Action Plan (CAP) policy and renaming the oversight committee to 'Delegated Provider Performance Governance.' These changes strengthen accountability and performance monitoring for PPGs in the Medi-Cal program. Billing teams should review updated provider manuals for any workflow impacts related to performance reporting and JOM (Joint Operations Meeting) documentation requirements.
Action Required
Billing team should: (1) Review the updated Provider Manual in the Provider Library under 'Provider Oversight' section to understand any changes to performance documentation or reporting requirements; (2) Ensure awareness of the new Corrective Action Plan (CAP) policy in case performance issues affect claim processing or provider status; (3) Contact Provider Engagement representative at 888-893-1569 (CalViva Health Medi-Cal) if clarification is needed on how these governance changes impact billing workflows. No immediate action required unless provider receives CAP notice.