Stakeholder News, October 26, 2026

The California Department of Health Care Services (DHCS) October 26, 2026 stakeholder bulletin announces several discrete Medi-Cal program developments. DHCS received the 2026 NAMD Spotlight Award for CalAIM Community Supports, which have reached more than 500,000 Medi-Cal members and delivered more than 1.5 million services since the 2022 launch. Analyses submitted to CMS associate Community Supports with reductions in emergency department visits, inpatient hospitalizations, and institutional long-term care utilization, with ten of the twelve evaluated services already demonstrating net Medicaid savings. DHCS is updating Medi-Cal enrollment requirements for doula providers. Effective December 3, 2026, doulas applying under the Experience Pathway must submit a recommendation letter from a Medi-Cal-enrolled community-based organization and provide proof of adult and infant CPR certification from the American Red Cross or American Heart Association. A public hearing on the draft provider bulletin was scheduled for October 27, 2026, with a stakeholder comment deadline of 5 p.m. PDT that same day. DHCS published a Medi-Cal Fee-for-Service Provider Toolkit in advance of the January 1, 2027 transition of Medi-Cal members with unsatisfactory immigration status from managed care to FFS. The toolkit covers provider enrollment and revalidation, eligibility verification, billing and claims processes, Treatment Authorization Requests, transportation services, and continuity of care obligations. Beginning January 1, 2027, some Medi-Cal adults ages 19 to 64 will be subject to new coverage requirements under which they may need to work, attend school, participate in job training, or volunteer to maintain Medi-Cal eligibility. DHCS scheduled a Coverage Ambassador webinar for November 19, 2026, to explain applicability, exemptions, and member preparation. On October 23, DHCS and CDPH jointly launched the Population Health Management Local Planning Technical Assistance Program, running through June 2029, to support Medi-Cal managed care plans, local health jurisdictions, and county behavioral health plans in collaborative community health planning under CalAIM.