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California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more
California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more

22-1032 Give Advance Notice for Terminations or Practice Location Changes

Date: 11/29/22

Ensure Medi-Cal members have access to care

All physicians and other 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

All termination notices will be made effective on the first of the month, approximately 60 days after the plan receives the notice, unless the stated effective date is further out. For example, a termination notice received January 10 will be effective April 1. Providers and delegated entities must ensure access for Medi-Cal members remains available during that time.

Use any of the below methods to submit prior notice

DHCS requirement

The Department of Health Care Services (DHCS) requires Medi-Cal managed care plans (MCPs) to have a sufficient network of providers to ensure members have timely access to care. MCPs must give prior notice to members and DHCS when there is a change in location or available services in the MCP’s network, all subject to DHCS approval.

The required prior notice applies to all physicians and other providers, including, but not limited to, primary care physicians (PCPs), specialists, ancillaries, hospitals, clinics and delegated entities; no exceptions. CHWP will notify DHCS and members affected by PCP, clinic, medical group, or hospital changes. Delegated entities must also properly notify their affected members when specialists from whom they were receiving care leave the network.

 

This information applies to Physicians, Independent Practice Associations (IPAs), Hospitals, Ancillary providers, Community Supports (CS) Providers, and Enhanced Care Management (ECM) Providers.