23-761m HIP Incentive Program Offered Through December 31, 2023
Date: 08/10/23
Receive $75 Confirmation of Pregnancy Incentive
The Confirmation of Pregnancy Incentive is part of the 2023 HEDIS®1 Improvement Program (HIP). This financial incentive recognizes and rewards HIP participating Medi-Cal primary care physicians (PCPs) for identifying pregnant members and ensuring timely access to prenatal care.
Meet HIP minimum requirements
PCPs must meet the minimum requirements of HIP to qualify for this supplemental compensation, which include:
- Currently contracting with Health Net or a contracted PPG under the Medi-Cal program.
- Providers who have no licensing or credentialing restrictions and are in good standing with Health Net and their PPGs.
- Accurately completing, in its entirety, and returning the Confirmation of Pregnancy within the required time frames. Signatures must be included.
Use the Confirmation of Pregnancy Form
To receive the $75 incentive payment, document the pregnancy visit by completing a Confirmation of Pregnancy Form when:
- Member confirms their pregnancy in the first trimester, or
- Within 42 days of enrolling in Medi-Cal with Health Net.
Before faxing the form, ensure the following is included on it to receive the incentive:
- Member information.
- Pregnancy information.
- Rendering practitioner.
How to access the form
A fillable version of the Confirmation of Pregnancy Form (PDF) is available on the Provider Library.
When are incentives processed
On a semiannual basis, $75 will be paid for each complete and accurate Confirmation of Pregnancy Form faxed to
Health Net prior to the close of 2023.
Incentive separate from base compensation
HIP is not considered part of the base provider compensation under the Health Net Medi-Cal Provider Participation Agreement (PPA) and is separate from contracting rates with the PPG.
The Confirmation of Pregnancy is supplemental compensation offered to PCPs. Those who submit Confirmation of Pregnancy Forms for the incentive will be paid for correctly completed Confirmation of Pregnancy Forms faxed within the required time frames.
Additional information
If you have questions regarding the information contained in this update, contact the Health Net Medi-Cal Provider Services Center at 800-675-6110.
1 HEDIS–Healthcare Effectiveness Data and Information Set
This information applies to Physicians.
For Medi-Cal, this information applies to Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.