26-849 Provider Communications Posted Online and Operations Manual Updates for June 2026
Date: 07/08/26
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 in June 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.
Communications posted online in June 2026
Date, number and title | Type of notice | Audience | Summary |
|---|---|---|---|
6/12/26 26-738m (PDF), Follow Access to Care Standards to Ensure Patients Get Timely Care | Regulatory | PPGs
| Health plans must maintain provider networks that can serve both adult and pediatric patients across their service areas. This notice outlines the access to care standards that must be met and what to do if gaps are identified. |
6/15/26 26-703m (PDF), Access the HEDIS® Resource Page for the Latest Tip Sheets | News & Announcements | Physicians/ Practitioners PPGs Hospitals Ancillary ECM CS Behavioral Health | Visit the HEDIS Measures & Billing Codes resource page to access tip sheets. The tip sheets provide current Healthcare Effectiveness Data and Information Set (HEDIS®) measurement descriptions, eligible populations, exclusions, documentation and coding requirements, and best practice guidance. |
6/26/26 26-688m (PDF), Enhancing Patient Experience Through Timely Access | News & Announcements | Physicians/ Practitioners PPGs Hospitals Ancillary ECM CS Behavioral Health | This flyer has been updated since its February 2026 release to include current appointment wait time standards. Adhering to these standards helps providers meet regulatory requirements and improve the patient experience. |
6/29/26 26-817m, Updates to Clinical Policies – May 2026 | Contractual | Physicians/ PPGs Behavioral Health | Review changes to medical policies for procedures and services for May 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. |
6/30/26 26-804m (PDF), Avoid Denials and Payment Delays: Billing Requirements for Dyadic Services | News & Announcements | Behavioral Health | Explains how behavioral health providers should bill for dyadic services. While services may include support for a parent or caregiver, they must directly support the child’s needs. |
Medi-Cal Provider Operations Manual changes in June 2026
Effective Date | Document name (and path) | Audience1 | Summary |
|---|---|---|---|
6/9/26
| Mandatory Notification Requirements for PPG Downstream Hospital Terminations (under Provider Oversight > Facility and Physician Additions Changes and Deletions) | All | Updated documents with information related to expanded notification requirements for PPG and hospital network terminations, including earlier reporting expectations, required information and compliance obligations to support timely regulatory review and approval. These changes are related to the Department of Health Care Services (DHCS) All Plan Letter 25-019. |
|
(under Provider Oversight > Facility and Physician Additions Changes and Deletions) | |||
6/12/26 | Medi-Cal Participation Requirements for Reimbursement (under Claims and Provider Reimbursement)
| All | New document explaining that Medi-Cal reimbursement is based on the rendering provider’s participation status, not the group contract. Rendering providers must be credentialed, enrolled with DHCS and listed on the provider roster at the time of service. Claims may be denied if these requirements are not met. |
6/25/26 | Financial Risk Responsibilities (under Benefits > Transplant) |
| New document explaining financial responsibility for major organ transplant services assigned under the Division of Financial Responsibility (DOFR), including post-transplant services based on the time since discharge. |
1All – The provider operations manual document applies to physicians/practitioners, PPGs, hospitals and ancillary providers, unless noted otherwise.
If you have questions regarding the information contained in this update, contact Community Health Plan of Imperial Valley at 833-236-4141. Behavioral health providers can call 844-966-0298.
This information applies to Medi-Cal in Imperial County.