26-598 Provider Communications Posted Online and Operations Manual Updates for April 2026
Date: 05/07/26
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The tables below outline provider communications posted online and operations manual changes made in in April 2026.
- Communications posted online: Includes the posting date, material number and title, type of communication, applicable audience, and a summary of the communication.
- Medi-Cal 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.
Read the latest issue of the spring Provider Pulse newsletter
Check out the spring issue for details on how we are working to support you, your patients and your community. Topics in this issue include:
- Investing in Students Today to Improve Care Tomorrow
- From Referrals to Results: Stronger Care Coordination in Calaveras County
- New California Department of Health Care Services Webpages: Federal Policy Impacts on Medi-Cal
- Doula Services are Available at No Cost to Members
Download the current and past issues in the Provider Library. Then, select the applicable line of business > Provider Pulse Newsletter.
Communications posted online in April 2026
Date, number and title | Type of notice | Audience | Summary |
|---|---|---|---|
4/1/26 26-417m (PDF), Medication Trend Updates and Drug List/Formulary Changes – 2nd Quarter 2026 | Contractual | Physicians/ PPGs | Discover what drug list and formulary changes and medication safety issues have been made in the 2nd quarter of 2026. |
4/14/26 26-482m, Complete Initial Health Appointments for New Members | Regulatory | Physicians/ PPGs Hospitals Ancillary | Learn more about the requirements and importance of completing initial health appointments (IHAs) for new primary care members. This notice outlines key components, provider responsibilities and where to find further guidance. |
4/17/26 26-532m (PDF), Updates to Clinical Policies – March 2026 | Contractual | Physicians/ PPGs Behavioral Health | Review changes to medical policies for procedures and services for March 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. |
4/28/26 26-578m, Early Pregnancy Confirmation Incentive | News & Announcements | Physicians/ PPGs Behavioral Health | Find out how primary care physicians can earn a $75 incentive for each eligible Medi‑Cal member whose pregnancy is confirmed early. The Pregnancy Confirmation Incentive supports timely access to prenatal care. |
Medi-Cal Provider Operations Manual changes in April
Effective Date | Document name (and path) | Audience | Summary |
|---|---|---|---|
4/7/26
| Behavioral Health Contact Information (under Contacts)
| All | Updated functions and descriptions/contact information for behavioral health providers. |
4/23/26 | Mandatory Notification Requirements for PPG Downstream Hospital Terminations (under Provider Oversight > Facility and Physician Additions, Changes and Deletions) | All | New document added regarding required notification requirements for PPGs when a hospital terminates from their network. These changes are derived from the Department of Managed Health Care All Plan Letter 25-019, effective as of January 1, 2026. |
4/27/26 |
(under Eligibility > Steps to Determine Eligibility) | All | Revised documents to remove references to the “Save Time Navigating the Provider Portal” brochure and added details about features available to providers on both the Health Net and Availity provider portals. |
How to Secure Prior Authorization on the Provider Portal (under Prior Authorization) | |||
Accessing Claims on the Provider Portal (under Claims and Provider Reimbursement) |
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.
This information applies to Medi-Cal in Imperial County.