25-838 Correction for Provider Update 25-728

Date: 08/15/25

Clarification on penalty payments for late-paid claims under AB 3275

On July 23, 2025, Health Net, on behalf of Community Health Plan of Imperial Valley, released Provider Update 25-728, “Claims Will Be Paid Faster Thanks to New California Law,” to inform providers about new claims processing timelines and penalties under Assembly Bill (AB) 3275, effective January 1, 2026.

This notice is being issued to clarify the section regarding penalty payments for late-paid claims.

Clarification

Beginning January 1, 2026, if a plan fails to include the required interest payment on a late-paid claim, it must also pay the claimant a penalty fee equal to the greater of fifteen dollars ($15) or 10 percent of the accrued interest.

This penalty applies only when the interest due is not paid automatically, as required by law. The original update did not clearly state that the penalty is tied to the failure to pay interest, not simply to the lateness of the claim itself.

All other information in Provider Update 25-728 remains accurate and unchanged.

Additional Information

The Department of Managed Health Care (DMHC) may issue further guidance on AB 3275 through December 31, 2027. Any updates impacting providers will be communicated accordingly.

For more information on AB 3275, please visit: Assembly Bill No. 3275.

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 Community Health Plan of Imperial Valley at 833-236-4141.
 

This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, and Ancillary Providers.

This information applies to Medi-Cal in Imperial County.