MedicaidReimbursementHigh impact
Provider Bulletin 05-02-2025 Targeted Rate Increase: Capitated Subcontractors Frequently Asked Questions IE LA SAC SD
Molina Healthcare·CA · Family Medicine, Internal Medicine, General Practice +2 more·Provider Bulletin
Effective date
Jan 1, 2024
We identified it
Jun 19, 2026
Summary
Molina Healthcare of California implemented Targeted Rate Increases (TRI) for capitated subcontractors serving Medi-Cal patients, effective retroactively to January 1, 2024. The enhanced capitation rates include former Proposition 56 physician payments, and IPAs must ensure downstream providers receive at least the minimum TRI fee schedule rates for primary care, obstetric, and non-specialty mental health services.
Action Required
Immediately: If contracted as a capitated subcontractor with Molina Healthcare California, review the Regulatory Amendment received by December 1, 2024 for new TRI enhanced capitation rates. Complete provider attestation at molinahealthcare.surveymonkey.com/r/3H3JT3D if applicable. Ensure downstream providers receive payment equal to or exceeding TRI minimum fee schedule rates for primary care, obstetric, and mental health services. Complete retroactive payment adjustments where necessary for services from January 1, 2024 forward.