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10-01-2026 Important information for CCS Paneled Providers: Transition of certain Medi-Cal Members from managed care to fee-for-service (FFS) effective January 1, 2027
Effective date
Jan 1, 2027
Identified
Oct 7, 2026
Summary
Effective January 1, 2027, certain Medi-Cal members with Unsatisfactory Immigration Status (UIS) will transition from Molina Healthcare managed care to Medi-Cal Fee-for-Service (FFS). CCS-paneled providers must continue authorized services through December 31, 2026, then prepare to bill under FFS requirements if they participate in the FFS network. Providers should verify FFS participation status and engage in care coordination before the transition to minimize service disruptions.
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What to do
Action · 6 steps
01Before January 1, 2027.
02Billing team and CCS providers should verify current Medi-Cal FFS participation status by contacting Molina Provider Relations or confirming enrollment through the CMS Panel Application and Medi-Cal Provider Portal to determine if the practice can continue serving affected members after the transition.
03Billing team should review and update billing workflows, authorization procedures, and enrollment requirements specific to Medi-Cal FFS billing, as the administrative process will change from managed care to fee-for-service on January 1, 2027.
04Clinical and care coordination staff should collaborate with county CCS administrators, PCPs, specialists, and community organizations to coordinate transition planning and minimize care disruptions for affected members.
05If FFS participation is not possible, providers should identify and communicate alternative Medi-Cal FFS providers to affected members.
06Providers may use the DHCS Medi-Cal Fee-for-Service Provider Finder to locate participating alternatives.
If missed: Failure to prepare may result in billing claim denials if the practice is not properly enrolled in Medi-Cal FFS or if billing procedures are not aligned with FFS requirements.
Original notice
10-01-2026 Important information for CCS Paneled Providers: Transition of certain Medi-Cal Members from managed care to fee-for-service (FFS) effective January 1, 2027
molinahealthcare.com · Always check the source before changing claims.