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California DHCS (Medi-Cal) · October 24, 2026 · Primary source

Stakeholder News, October 5, 2026

Score 73PRIMARYregulatoryState MedicaidCA

Summary

California DHCS's October 5, 2026 stakeholder newsletter reports several significant Medi-Cal policy changes taking effect in late 2026 and 2027. A federal rule effective October 13 bars use of federal Medicaid and CHIP funds for certain gender-affirming care services for youth, with California committing state-only funding and issuing All Plan Letter 26-018 to managed care plans to maintain provider reimbursement. Separately, DHCS implemented Medi-Cal eligibility changes under H.R. 1 on October 1, ending federal funding for some Qualified Non-Citizen members, with California extending state-funded full-scope Medi-Cal through July 1, 2027. DHCS also imposed temporary payment withholds on four county behavioral health plans (Merced, San Francisco, Santa Clara, and Shasta) for failing to meet network adequacy and timely access standards under BHIN 25-013 for two consecutive certification years.

What this may mean

The temporary withholds on four county behavioral health plans are direct financial enforcement actions, with release of funds contingent on demonstrated compliance with network adequacy and timely access standards. Medi-Cal managed care plans must implement All Plan Letter 26-018 governing gender-affirming care for youth, distinguishing federally funded from state-funded services. The H.R. 1 eligibility changes require managed care plans to prepare for the January 1, 2027 transition of Qualified Non-Citizen members from managed care to fee-for-service.

Informational only. Not legal, medical, financial, or other professional advice. Always consult a qualified professional familiar with your specific facts before relying on any item.

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