26-933 DHCS Confirms Expiration of the Temporary Federal Payment Restriction Under H.R. 1
Date: 08/11/26
Affected Medi-Cal providers may resume claims submission beginning July 4, 2026
The California Department of Health Care Services (DHCS) issued All Plan Letter (APL) 26-013, confirming that the one-year federal payment restriction for certain providers classified as prohibited entities under H.R. 1 ended on July 4, 2026.
What this means for you
- Affected providers may resume submitting claims and encounters for covered Medi-Cal services provided to members with dates of service on or after July 4, 2026.
- Claims and encounters submitted for covered Medi-Cal services will be processed through standard claims adjudication procedures.
- This update supersedes the guidance communicated in provider update 25-1073 regarding the temporary federal payment restriction from APL 25-011. You can access provider update 25-1073 in the Medi-Cal Provider Library under Provider Updates and Notices.
Additional information
For additional information about DHCS APL 26-013, visit
DHCS - ALL PLAN LETTER 26-013.
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. Behavioral Health providers can call 844-966-0298.
This information applies to Physicians and 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 Fresno, Kings and Madera counties.