25-785 New Updates to CS and ECM Provider Reference Guides
Date: 08/25/25
Find them at CalAIM Resources for Providers
To meet Medi-Cal contract requirements, Health Net, on behalf of CalViva Health, has conducted a comprehensive review of the Community Supports (CS) and Enhanced Care Management (ECM) provider reference guides.
Key revisions
Based on this comprehensive review, we revised key sections of these guides to reflect recent changes from the Department of Health Care Services, along with administrative and Plan updates. See below for the revised sections.
Community Supports:
- Section 1: Introduction
- Section 2: Provider Certification Application
- Section 8.2: Provider Portal for Authorization
- Section 11.1: Monitoring and Support Overview
- Section 14: Resources
Enhanced Care Management:
- Section 1: Introduction
- Section 3.5.1: ECM Provider Care Team Staffing
- Section 3.5.3: Provider Caseloads
- Section 3.5.4: Staffing and Capacity Report
- Section 4.1: ECM Eligibility Criteria
- Section 4.2.1: ECM Provider Expectations
- Section 4.3.2.3: ECM Community Initiated Eligibility Referrals
- Section 4.3.2.4: Communication with Referring Entity (New)
- Section 4.4.1: ECM Provider Conducted Outreach
- Section 4.11: Member Discontinuation
Additional information
If you have questions regarding the information contained in this update, contact CalViva Health at 888-893-1569.
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, Ancillary Providers, Community Supports (CS) Providers, and Enhanced Care Management (ECM) Providers.
This information applies to Medi-Cal in Fresno, Kings and Madera counties.