24-554m Reminder: HIP Incentive Program Offered Through December 31, 2024
Date: 06/18/24
Receive $75 Incentive for Confirmation of Pregnancy
The Confirmation of Pregnancy Incentive is part of the 2024 HEDIS®1 Improvement Program (HIP). This financial incentive recognizes and rewards participating HIP 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 includes:
- Currently contracting with Health Net, on behalf of CalViva Health, or a contracted PPG under the Medi-Cal program.
- Having no licensing or credentialing restrictions and are in good standing with the Plan and their PPGs.
- Accurately completing, in its entirety, and returning the Confirmation of Pregnancy form 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 will be available on the Provider Library at
Confirmation of Pregnancy form (PDF).
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 2024.
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
Relevant sections of the provider operations manuals have been revised to reflect the information contained in this update as applicable. Provider operations manuals are available electronically in the Provider Library on the
provider portal.
Providers are encouraged to access the provider portal for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.
If you have questions regarding the information contained in this update, contact CalViva Health at 888-893-1569.
1HEDIS–Healthcare Effectiveness Data and Information Set
This information applies to Physicians.
This information applies to Medi-Cal in Fresno, Kings and Madera counties.