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[California] Transition of Enhanced Care Management UIS members to Medi-Cal Fee-for-Service
Act
by Dec 31, 2026
Effective date
Jan 1, 2027
Identified
Oct 27, 2026
Summary
Effective January 1, 2027, Medi-Cal members with unsatisfactory immigration status (UIS) will transition from Anthem Blue Cross Medi-Cal Managed Care to Medi-Cal Fee-for-Service (FFS). Enhanced Care Management (ECM) services will no longer be available to these members under FFS; providers must complete transition planning, care coordination, and warm handoffs by December 31, 2026. Providers wishing to continue serving these members must enroll as Medi-Cal FFS providers and bill under FFS coverage policies.
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What to do
by Dec 31, 2026 · 12 steps
01ECM care providers serving transitioning UIS members must.
02Coordinate with the member's full care team to minimize service disruptions.
03Confirm whether current care providers can continue services through Medi-Cal FFS.
04Identify alternative Medi-Cal FFS providers when transitions are necessary.
05Assess member eligibility for other available services (Medi-Cal FFS care management, CHW services, behavioral health, HCBS, county programs).
06Develop a transition plan with member input and share securely with care team and Anthem via Care Central.
07Complete warm handoffs to receiving Medi-Cal FFS care providers when accepted.
08Before January 1, 2027: Any care providers not currently enrolled in Medi-Cal FFS who wish to continue delivering care coordination services must complete enrollment through DHCS Provider Enrollment Division (PED), including the PAVE portal at https://www.dhcs.ca.gov/providers-partners/provider-application-and-validation-for-enrollment/.
09Effective January 1, 2027: Stop billing Anthem for ECM services to transitioned UIS members; transition billing to Medi-Cal FFS under applicable FFS coverage policies.
10Verify current Medi-Cal FFS provider status and enrollment at https://data.chhs.ca.gov/dataset/profile-of-enrolled-medi-cal-fee-for-service-ffs-providers.
11Providers billing for CHW services must meet Medi-Cal FFS supervising provider requirements.
12Contact CHWBenefit@dhcs.ca.gov for CHW benefit questions.
Original notice
[California] Transition of Enhanced Care Management UIS members to Medi-Cal Fee-for-Service
providernews.anthem.com · Always check the source before changing claims.
Related changes
See all Anthem BCBS changes →[California] TCS care providers: UIS member transition to Medi-Cal FFSHighEffective Jan 1, 2027 · Provider Bulletin[California] Continuing Community Health Worker services following the UIS transitionHighEffective Jan 1, 2027 · Provider Bulletin[California] UIS resident coverage transition to Medi-Cal FFSMediumEffective Jan 1, 2027 · Provider Bulletin[California] Important information regarding UIS transition to Medi-Cal Fee-for-ServiceHighEffective Jan 1, 2027 · Provider BulletinBrowse every Anthem BCBS change in the policy list