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New Medi-Cal Providers Web Page: Medi-Cal Managed Care to Fee-for-Service Transition
Act
by Dec 31, 2026
Effective date
Dec 31, 2026
Identified
Sep 30, 2026
Summary
Medi-Cal members with Unsatisfactory Immigration Status (UIS) will transition from managed care to fee-for-service coverage effective December 31, 2026. Providers currently enrolled only in Medi-Cal managed care must enroll in fee-for-service billing and update their systems to handle Treatment Authorization Requests (TARs) and fee-for-service billing requirements, or they will lose the ability to serve these members.
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What to do
by Dec 31, 2026 · 7 steps
01Billing team must complete the following actions.
02Update PAVE enrollment to ensure the practice is enrolled in Medi-Cal fee-for-service in addition to managed care.
03Confirm all enrollment, screening, and revalidation requirements are current in the billing system.
04Review and implement fee-for-service billing requirements, including Treatment Authorization Request (TAR) processes and procedures.
05Update capacity and member status information in all systems to reflect whether the practice is accepting new fee-for-service Medi-Cal members.
06Failure to complete enrollment and update billing processes before the deadline will result in loss of ability to bill and care for all Medi-Cal members with UIS.
07Immediately: Contact Medi-Cal Providers website and DHCS Transition to Medi-Cal Fee-for-Service web page for updated resources and training announcements.
Original notice
New Medi-Cal Providers Web Page: Medi-Cal Managed Care to Fee-for-Service Transition
mcweb.apps.prd.cammis.medi-cal.ca.gov · Always check the source before changing claims.