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26-576m Early Pregnancy Confirmation Incentive

Date: 04/28/26

Confirm pregnancy early and earn $75 per eligible Medi‑Cal member

Primary care physicians (PCPs) participating in the 2026 HEDIS®1 Improvement Program (HIP) may earn a $75 incentive for each eligible Medi‑Cal member whose pregnancy is confirmed early. This supplemental incentive supports timely access to prenatal care.

How to qualify

PCPs must:

  • Be contracted under the Medi-Cal program.
  • Be in good standing with no licensing or credentialing restrictions.
  • Submit a complete and accurate Confirmation of Pregnancy Form (PDF), including the required signature, within the required timeframe (see below).

When to submit

Submit the Confirmation of Pregnancy form when:

  • The member’s pregnancy is confirmed during the first trimester, or
  • Within 42 days of the member’s Medi-Cal enrollment.

Payment details

  • $75 per eligible submission.
  • Payments are issued semi-annually.
  • Forms must be received by December 31, 2026.

Program details

  • This incentive is separate from base Medi-Cal compensation. 
  • It does not impact participating physician group contracting rates.
  • Only forms that are complete and submitted on time are eligible for payment.

The Confirmation of Pregnancy Form (PDF) is available in the Provider Library under Forms and References. Submission instructions are included on the form.

Need help? Contact us

If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by phone at 800-675-6110 or through the Health Net provider portal.

1HEDIS: Healthcare Effectiveness Data and Information Set
 

This information applies to Physicians.

For Medi-Cal, this information applies to Amador, Calaveras, Inyo, Los Angeles, Molina, Mono, Sacramento, San Joaquin, Stanislaus, Tulare and Tuolumne counties.
 



Last Updated: 04/27/2026