26-958 Provider Communications Posted Online and Operations Manual Updates for July 2026
Date: 08/07/26
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The tables below outline provider communications posted online and operations manual changes made in in July 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.
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- Stronger Communities Through Housing and Workforce Investment
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Communications posted online in July 2026
Date posted | Number and title | Type of notice | Audience | Summary |
|---|---|---|---|---|
7/1/26 | 26-784m (PDF), Medication Trend Updates and Drug List/Formulary Changes – 3rd Quarter 2026 | Contractual | Physicians/Practitioners PPGs | Discover what drug list and formulary changes have been made and medication safety issues released in the 3rd quarter of 2026. |
7/17/26 | 26-872m (PDF), Updates to Clinical Policies – June 2026 | Contractual | Physicians/ PPGs Behavioral Health | Review changes to medical policies for procedures and services for June 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. |
7/28/26 | 26-909m, Improve Patient Safety with No-Cost Quality Resources | News & Announcements | Hospitals
| Find out about no-cost resources and expert support available to help hospitals improve patient safety and quality performance. The resources provide benchmarking data, analytics, and quality improvement tools to help identify performance gaps, monitor progress, and enhance patient outcomes. |
Medi-Cal Provider Operations Manual changes in July 2026
Effective Date | Document name (and path) | Audience1 | Summary |
|---|---|---|---|
7/6/26
| Coverage Explanation | All
| Updated documents with information related to billing for prenatal screenings and required services for CPSP, as derived from requirements related to DHCS All Plan Letter 26-005. |
Comprehensive Perinatal (under Benefits > Maternity) | |||
7/21/26 |
(under Encounters> | All | Updated documents with information related to Quality Measures for Encounter Data (QMED 2.0) requirements, specifically reinforcing timely, accurate, and complete encounter data submission for capitated providers. |
|
(under Encounters> | |||
Noncompliance with Encounter Data Submission | |||
Professional and Institutional Capitated Encounter Submission Requirements | |||
7/21/26 | Hospice Care | All | Updated document with information to reflect current guidance for hospice care services and claims processing. Changes included revised documentation requirements for hospice prior authorization requests and a new version of the Hospice Services Documentation Guide. |
Hospice Services Documentation Guide (PDF) (under Forms and References) | |||
7/24/26 | Long-Term Care | All | The Long-Term Care Authorization Notification Form and related operations manual section have been updated to align with requirements in DHCS All Plan Letter 25-008. Effective July 9, 2026, prior authorization requests must be submitted by fax using the authorization notification form and required attachments. Submissions are no longer accepted via email. |
Long-Term Care Authorization Notification Form (under Forms and References) |
1All – The provider operations manual document applies to physicians/practitioners, PPGs, hospitals and ancillary providers, unless noted otherwise.
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 Imperial County.