26-438 Provider Communications Posted Online and Operations Manual Updates for March 2026
Date: 04/07/26
Access the Provider Library for the latest operational and Plan updates and changes to better service your patients
The tables below outline provider communications posted online and operations manual changes made in March 2026.
- Communications posted online: Includes the posting date, material number and title, type of notice, applicable audience and lines of business, and a summary of the communication.
- Provider operations manual changes: Includes the effective date of the change, document name (and path to section where document is located), audience, affected lines of business and URLs, and a summary of the change.
Communications posted online in March 2026
Date, number and title | Type of notice | Audience | Lines of business | Summary |
|---|---|---|---|---|
3/2/26 26-191m (PDF), Stay Informed About Quality Goals and Activities to Improve Members’ Health | News & Announcements | Physicians/ PPGs Hospitals Ancillary ECM CS Behavioral Health | Medi-Cal (all counties)
| Learn what progress has been made and what still needs improvement based on 2025 Healthcare Effectiveness Data and Information Set (HEDIS®) quality performance results.
|
3/2/26 26-264m (PDF), Medicare Tier 6: Select Care Drugs | News & Announcements | Physicians/ PPGs Hospitals
| Medicare Advantage (HMO) | A new resource that provides you with a high-level benefits overview of eligible Tier 6 medications. These medications usually have no cost compared to other higher tiered medications. Eligible medications are listed by category under high blood pressure, high cholesterol and diabetes. |
3/11/26 26-287m (PDF), Act Now: Keep Your Provider Demographic Information Accessible to Members | Regulatory | Physicians/ PPGs Hospitals Ancillary ECM CS Behavioral Health | IFP (Ambetter HMO/PPO) Employer Group Medi-Cal (all counties)
| Reminder: Find out how to keep your information current to avoid removal from the provider directory.
|
26-288m (PDF), Act Now: Keep Your Provider Demographic Information Accessible to Members | Medicare Advantage (HMO) | |||
3/16/26 26-283m, New State-Mandated Chaperone Requirements for Sensitive Ultrasound Exams Start January 1, 2027 | Regulatory | Physicians/ PPGs Hospitals Ancillary ECM CS
| IFP (Ambetter HMO/PPO) Employer Group Medi-Cal (all counties) Molina | Review and be prepared for notification, training and documentation procedures tied to new state-mandated medical chaperone notification requirements for sensitive ultrasound examinations that go into effect January 1, 2027. |
3/20/26 26-342m (PDF), Preferred Pharmacy Network (2026 Medicare Advantage Part D and Prescription Drug Plan) | News & Announcements | Physicians/ PPGs Hospitals Ancillary | Medicare Advantage (HMO) | Learn how our preferred pharmacy network can help lower prescription costs for your patients, which supports medication adherence and better health outcomes. You and your patients can easily confirm pharmacy coverage and options using online search tools, making care simpler and more convenient. |
3/20/26 26-344m (PDF), Part D Coverage of Insulin and Biosimilar | News & Announcements | Physicians/ PPGs Hospitals Ancillary | Medicare Advantage (HMO) | Discover how Medicare Part D helps keep insulin costs low and predictable for patients, including access to safe and effective biosimilar options. Lower and consistent insulin costs can improve medication adherence, helping patients better manage diabetes and stay healthier. For you, this means fewer cost-related treatment disruptions and more confidence that prescribed insulin therapies are affordable for your patients. |
3/20/26 26-355m, Updates to Clinical Policies – February 2026 | Contractual | Physicians/ PPGs Behavioral Health | IFP (Ambetter HMO/PPO) Employer Group Medi-Cal (all counties)
| Review changes to medical policies for procedures and services for February 2026. Medical policies are available online. Medical policies offer guidelines for determining medical necessity for certain procedures, equipment and services. As a reminder, all services must be medically necessary, and member benefits, legal and regulatory mandates take precedence over content of medical policies and must be applied first. |
3/23/26 26-267m (PDF), Enhancing Patient Experience Through Timely Access | News & Announcements | Physicians/ PPGs Hospitals Ancillary ECM CS Behavioral Health | IFP (Ambetter HMO/PPO) Employer Group Medi-Cal (all counties)
| Help guarantee timely access to care and improve overall patient experience by following these standards for patient appointments. |
26-270m (PDF), Enhancing Patient Experience Through Timely Access | Medicare Advantage (HMO) | |||
3/24/26 26-375m, Respite Services Authorization Form Updated | Contractual | CS
| Medi-Cal (all counties)
| The Respite Services Authorization Form has been updated to include required billing codes. Find the updated form on the CalAIM Resources for Providers page or access it through the online communication. |
Provider operations manual changes in March 2026
Effective Date | Document name (and path) | Audience1 | Lines of business and URL | Summary |
|---|---|---|---|---|
3/10/26
| Therapeutic Injections and Other Injectable Substances (under Benefits > Injectables) | All | The Injectable Medication HCPCS/DOFR Crosswalk was updated for the fourth quarter of 2025.
| |
3/5/26 | Hospice Care (under Benefits) | All | Document updated to clarify that PPGs and providers must submit a referral with complete hospice documentation to Health Net within 5 calendar days when Health Net is at financial risk for hospice services. | |
3/3/26 | Bariatric Surgery Performance Centers (under Forms & References) | All | The Bariatric Surgery Performance Centers list has been updated. | |
3/24/26 | Palliative and Hospice Care Contracted Provider List (under Forms & References) | All | The Palliative Care Contracted Provider List has been renamed the Palliative and Hospice Care Contract Provider List. The list was also updated and separated into two groups – preferred and secondary. Fax numbers, provider websites and a column noting if hospice care is offered are now included. | |
3/31/26 | Application Process (under Credentialing) | All |
| Updated Credentialing section to reflect information from Assembly Bill 1041, which requires health plans to make a credentialing decision within 90 calendar days of receiving a completed credentialing application. If this deadline is not met, providers will receive provisional approval for up to 120 days, unless statutory exceptions apply. Additionally, minor wording and formatting updates were made throughout document to ensure consistency. |
1All – The provider operations manual document applies to physicians/practitioners, PPGs, hospitals and ancillary providers, unless noted otherwise.
This information applies to Physicians, Practitioners, Participating Physician Groups (PPGs), Hospitals, Ancillary Providers, Community Supports (CS) Providers, Enhanced Care Management (ECM) Providers, and Behavioral Health Providers.
For Medi-Cal, this information applies to Amador, Calaveras, Inyo, Los Angeles, Molina, Mono, Sacramento, San Joaquin, Stanislaus, Tulare and Tuolumne counties.