26-560 Mandatory Notification Requirements for PPG Downstream Hospital Network Terminations
Date: 04/23/26
Participating physician groups are required to notify health plans of contracted hospital terminations
Effective January 1, 2026, pursuant to the Department of Managed Health Care (DMHC) All Plan Letter 25‑019 (issued on December 12, 2025), the DMHC amended 28 CCR § 1300.51, 1300.67.1.3 and 1300.67.2. Under these regulatory updates, you are required to notify Health Net, on behalf of CalViva Health, when a contracted hospital may potentially terminate from your network.
What you need to know
When a contracted hospital terminates from your network for any reason, including partial terminations, constructive terminations, novations, non-renewal, and contract assignments, you must notify the Plan.
Timely notification allows the Plan to:
- Maintain accurate provider directories.
- Meet reporting and member notice requirements.
- Ensure appropriate continuity of care (COC) protections for impacted members.
Downstream hospital terminations require a Block Transfer Filing. Under DMHC rules, hospital network terminations that may impact member access or COC require the Plan to submit a Block Transfer Filing to the DMHC. Timely notification from you is required to allow the Plan to evaluate filing requirements and meet regulatory timelines.
When and where to send notifications
You must notify your assigned Provider Engagement network specialist as soon as a hospital termination is known or anticipated, including planned non-renewals or early terminations, at least 180 days in advance. This must include termination details and effective dates to allow sufficient time for regulatory review.
Information you will be asked to provide
Be prepared to submit termination-related information through a standardized form at least 120 business days before the termination. The form will be provided by your assigned Provider Engagement network specialist.
Information must include, but is not limited to:
- Hospital termination notice and effective date.
- Hospital extension notice (if applicable).
- Enrollee notification materials and timing.
- COC approach and impacted members.
- Scope and impact of the termination, including affected lines of business.
Additionally, a terminating hospital may not be removed from the network until approval of the Block Transfer Filing has been obtained from the DMHC.
Escalation and consequences for noncompliance
Failure to provide timely and complete notification may result in corrective action and may impact the Plan’s ability to meet regulatory obligations, which could affect your delegation status.
Additional information about APL 25-019
For more information on APL 25-019 (PDF).
Need help? Contact us
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.
If you have questions regarding the information contained in this update, contact CalViva Health at 888-893-1569.
This information applies to Participating Physician Groups (PPGs).
This information applies to Medi-Cal in Fresno, Kings and Madera counties.