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Medi-Cal Fee-for-Service Provider Toolkit for UIS Transition is Available
Act
by Jan 1, 2027
Effective date
Jan 1, 2027
Identified
Nov 7, 2026
Summary
Medi-Cal published a provider toolkit to help providers prepare for the federal requirements starting January 1, 2027, under which Medi-Cal members with Unsatisfactory Immigration Status (UIS) who receive care through Medi-Cal fee-for-service will transition out of managed care. The toolkit covers accepting new patients, enrolling in Medi-Cal fee-for-service, verifying eligibility, TAR continuity, transportation services, and services available in both managed care and fee-for-service, and is posted on the Ordering, Referring and Prescribing and Medi-Cal Managed Care to Fee-for-Service Transition web pages.
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What to do
by Jan 1, 2027 · 4 steps
01Billing team should review the Medi-Cal Fee-for-Service Provider Toolkit on the Ordering, Referring and Prescribing and Medi-Cal Managed Care to Fee-for-Service Transition web pages and identify which of your patients are Medi-Cal members affected by the UIS transition.
02Billing team and front desk staff should confirm Medi-Cal fee-for-service enrollment for the practice, and verify eligibility for affected members in the eligibility verification workflow before scheduling.
03Billing team should review TAR continuity and transportation service billing guidance and update charge entry and claim routing for members moving to fee-for-service.
04Providers and front desk staff should be briefed on the toolkit's guidance about accepting new patients and on services available under both managed care and fee-for-service.
Original notice
Medi-Cal Fee-for-Service Provider Toolkit for UIS Transition is Available
mcweb.apps.prd.cammis.medi-cal.ca.gov · Always check the source before changing claims.