About Medi-Cal
More than 15 million Californians rely on Medi-Cal, the state’s version of the federal program known as Medicaid, for health insurance. The program acts as California’s health care coverage safety net, with those on Medi-Cal often living in communities with a lack of adequate health care providers. Without significant investments to support providers that deliver health care to California’s most vulnerable, millions living in rural and underserved areas are in jeopardy.
Summaries Detail Changes to Medicaid Payments, Work Requirements
What’s happening: CHA is sharing two analyses prepared by Health Policy Alternatives (HPA) that cover Medicaid rules on directed payments and targeted supplemental payments as well as the implementation of community engagement (work requirement) provisions.
Immediate Action Needed for Prescribers: Ensure Enrollment as Medi-Cal FFS Provider
What’s happening: Claims and prior authorizations will not be processed by Medi-Cal Rx if the prescribing health care provider is not enrolled in Medi-Cal fee-for-service (FFS) with a Type 1 National Provider Identifier. Prescribers not yet enrolled should immediately submit their Medi-Cal provider enrollment application via the Provider Application and Validation for Enrollment page.
Reminder: Include ICD-10-CM Diagnosis Codes on Medi-Cal Rx Claims
What’s happening: As a reminder, ICD-10-CM diagnosis codes will be required for Medi-Cal Rx claims starting this fall.
Fact Sheet: Medicaid in California
Medicaid in California
Medicaid is a lifeline to millions of Californians
Infographic: Protecting Access to Care for All Californians
DHCS’ Revised Prop. 35 Spending Plan Fails to Align with Voter Intent
What’s happening: At the May 28 “Protect Access to Health Care Act” Stakeholder Advisory Committee meeting, the Department of Health Care Services (DHCS) put forth a revised spending plan that fails to align funding with the intent of the voter-approved Proposition 35.
DHCS Launches 30-Day Comment Period for Renewal of CalAIM Waiver
What’s happening: The Department of Health Care Services (DHCS) has launched a 30-day public comment period — closing June 20 — on the planned submission of a five-year renewal application for the California Advancing and Innovating Medi-Cal (CalAIM) Section 1915(b) Waiver, which is scheduled to expire on Dec. 31, 2026.
State Resubmits Hospital Fee Program 9, Draft Model Available for Members
What’s happening: On May 15, the state submitted the payment policies for the next iteration of the Hospital Fee Program (Program 9) to the Centers for Medicare & Medicaid Services (CMS). This is the final piece needed for CMS to review the full application.
Comments Due in July for CMS’ Medicaid Supplemental Payments Proposal
What's happening: Yesterday, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule outlining changes to Medicaid supplemental payments, including managed care state-directed payments. This is some of the implementation rulemaking associated with the payment reductions Congress enacted in the One Big Beautiful Bill Act.
May Budget Revision Avoids Broad Health Care Cuts
What’s happening: Gov. Newsom’s May Revision to the proposed 2026-27 state budget reflects a stronger-than-expected revenue outlook that avoids broad cuts to health care while maintaining a cautious fiscal approach that includes significant changes to Medi-Cal coverage.