MedicaidAdministrativeMedium impact
Provider Bulletin 07-21-2025 Medi-Cal Enrollment Restrictions IE LA SAC SD
Molina Healthcare·CA·Medicaid
Effective date
Jul 21, 2025
We identified it
Jun 19, 2026
Summary
Molina Healthcare of California issued guidance on Medi-Cal enrollment restrictions affecting members with Hold Restrictions due to incomplete annual redetermination. Providers must verify eligibility through AVES or Availity and help guide members through the redetermination process, with retroactive coverage available if completed within 90 days.
Action Required
Immediately: Front desk staff must check Medi-Cal eligibility through AVES system or Molina's Availity portal before scheduling non-emergency services. If Hold Restriction appears, guide members to contact their local county Medi-Cal office and submit required redetermination documents within 90 days for retroactive coverage. Update verification procedures to identify and assist members with enrollment restrictions.