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10-27-2026 ECM, CICM, Community Supports, CCM, TCS and CHW services for Members transitioning to Medi-Cal Fee-for-Service
Act
by Dec 31, 2026
Effective date
Jan 1, 2027
Identified
Oct 31, 2026
Summary
Effective January 1, 2027, Medi-Cal managed care plan members with unsatisfactory immigration status will transition to the Medi-Cal Fee-for-Service delivery system. ECM, CICM, Community Supports, CCM and TCS services will no longer be covered for transitioned members in Medi-Cal FFS, while CHW services will continue to remain available after January 1, 2027. Managed care plans must continue authorizing, providing and paying for these services through December 31, 2026.
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What to do
by Dec 31, 2026 · 4 steps
01Complete a warm handoff of transitioning members to the receiving Medi-Cal FFS provider as soon as possible, and no later than that date, where the receiving provider is able to accept one; the receiving provider cannot receive reimbursement for the warm handoff.
02Before January 1, 2027: Coordinate with members' PCPs, other care management providers, behavioral health providers, county agencies, social service agencies and community-based organizations to minimize service disruptions; verify whether current providers can and are willing to continue in Medi-Cal FFS; where a provider transition is needed, identify alternative FFS providers using the DHCS Medi-Cal Fee-for-Service Provider Finder App; assess whether members may qualify for other Medi-Cal FFS services; and transmit member assessments and care management plans to the appropriate FFS providers with required privacy and confidentiality safeguards.
03To keep providing care management to FFS members on or after January 1, 2027, providers must be enrolled in Medi-Cal FFS through the PAVE portal and submit claims to Medi-Cal FFS starting January 1, 2027, when members have been transitioned.
04Watch for the updated Medi-Cal FFS billing codes for care management services that Molina says it will provide.
Original notice
10-27-2026 ECM, CICM, Community Supports, CCM, TCS and CHW services for Members transitioning to Medi-Cal Fee-for-Service
molinahealthcare.com · Always check the source before changing claims.