21-236 Give Advance Notice for Provider Terminations or Practice Location Changes

Date: 03/25/21

Ensure Medi-Cal members have access to care

All providers and delegated entities must give California Health & Wellness Plan (CHWP) sufficient advance notice of provider terminations in their network panel or of any service location changes. The required timeline is outlined in your Provider Participation Agreement (PPA) and/or CHWP policies.

Termination timeline

Unless the stated effective date is further out, all termination notices to CHWP for the Medi-Cal product will be made effective on the first of the month approximately 60 days from the end of the month of receipt by CHWP (e.g., notice received
January 10, termination will be effective April 1). Providers and delegated entities must ensure access for Medi-Cal members remains available during that time.

Use any of these methods to submit prior notice

• Email: CHWP_contracting@cahealthwellness.com
• Online: Complete the online form on the CHWP provider website under Provider > Provider Resources > Provider Data Reporting and Validation
• Call or email: Reach out to your provider relations & contracting specialist (PRCS)

DHCS requirement

Per the Department of Health Care Services (DHCS), Medi-Cal managed care plans (MCPs) are required to have a sufficient network of providers to ensure its members have timely access to care. MCPs also have prior notification requirements to members and to DHCS when there is a change in the location or availability of services in the MCP’s network, all subject to DHCS approval.