At Alameda Alliance for Health (Alliance), we value our dedicated provider partner community. We have an important announcement that we would like to share with you.

Effective Friday, January 1, 2027, Medi-Cal managed care plan (MCP) members with unsatisfactory immigration status (UIS) will transition to the Medi-Cal fee-for-service (FFS) delivery system.

For provider-specific information about the UIS transition to FFS, please select your provider type below.

California Children's Services (CCS) Providers

October 28, 2026

Dear Provider,

At Alameda Alliance for Health (Alliance), we value our dedicated provider partner community. We have an important update we want to share with you.
Effective Friday, January 1, 2027, Medi-Cal managed care plan (MCP) members with unsatisfactory immigration status (UIS) will transition to the Medi-Cal Fee-for-Service (FFS) delivery system.

As further outlined in this document, California Children’s Services (CCS) providers who have agreements with the Alliance, including Network Provider Agreements, Subcontractor Agreements, or Downstream Subcontractor Agreements, are required to actively support transitioning members to facilitate a smooth transition for providers and their patients. The California Department of Health Care Services (DHCS) is providing the following important information regarding provider enrollment, billing, and requirements for ongoing care responsibilities.

CCS Services

CCS providers must continue to deliver authorized services, per Alliance agreements, for all eligible members with UIS through Thursday, December 31, 2026. CCS services will continue to remain available to transitioned members after Friday, January 1, 2027.

Steps CCS Service Providers Can Take to Start or Continue Serving Transitioning Members

This transition creates a significant opportunity for providers to begin serving Medi-Cal FFS members or to expand their existing participation.

Enrolling in Medi-Cal FFS and CCS
CCS-paneled providers and specialty care centers are already Medi-Cal enrolled.

Below is additional information required to enroll in CCS:

Requirements for CCS Provider Care Coordination with Transitioning Members Prior to Friday, January 1, 2027

CCS providers who have agreements with the Alliance, including Network Provider Agreements, Subcontractor Agreements, or Downstream Subcontractor Agreements, must conduct transition planning and care coordination for members with UIS prior to Friday, January 1, 2027.

Required activities include, but are not limited to:

  • CCS providers must coordinate with members’ PCPs, other care management service providers, behavioral health providers, county agencies, social service agencies, and community-based organizations to minimize disruptions in services prior to the transition.
  • CCS providers must verify whether members’ current providers can and are willing to continue to provide services in the Medi-Cal FFS delivery system. In instances that provider transition is needed, CCS providers must identify alternative providers available to members post-transition within the Medi-Cal FFS delivery system using tools including, but not limited to, the DHCS Medi-Cal Fee-for-Service Provider Finder App by visiting www.dhcs.ca.gov/medi-cal/find-care.
  • CCS providers must also assess whether members may qualify for other available Medi-Cal FFS services, including Chronic Care Management, behavioral health services, home and community-based services, county-based programs, or other supports available under Medi-Cal FFS or local delivery systems.

Once new providers who will be receiving transitioning members are identified, current CCS providers must transmit member assessments and care management plans, ensuring compliance with all required data privacy and confidentiality safeguards, to the appropriate Medi-Cal FFS delivery system providers. If the receiving Medi-Cal FFS provider is able to accept a warm handoff, current and future CCS providers must complete that handoff as soon as possible, but no later than Thursday, December 31, 2026. The receiving provider will not be able to receive reimbursement for the warm handoff. Receiving providers may start providing services and submit bills and claims to Medi-Cal FFS starting Friday, January 1, 2027, when those members have been transitioned to the Medi-Cal FFS delivery system.

Questions & Support

DHCS has provided the resources below for more information:

The Alliance will provide additional information as DHCS finalizes transition updates, including:

  • Updated billing codes for Medi-Cal FFS care management services;
  • Member support pathways; and
  • Contact information for DHCS or MCP support channels.

Sincerely,
Alameda Alliance for Health

California Integrated Care Management (CICM) Providers

October 28, 2026

Dear Provider,

At Alameda Alliance for Health (Alliance), we value our dedicated provider partner community. We have an important update we want to share with you.

Effective Friday, January 1, 2027, Medi-Cal managed care plan (MCP) members with unsatisfactory immigration status (UIS) will transition to the Medi-Cal Fee-for-Service (FFS) delivery system.

As further outlined in this document, California Integrated Care Management (CICM) providers who have agreements with Alameda Alliance Wellness (HMO D-SNP), including Network Provider Agreements, Subcontractor Agreements, or Downstream Subcontractor Agreements, are required to actively support transitioning members to facilitate a smooth transition for providers and their patients. The California Department of Health Care Services (DHCS) is providing the following important information regarding provider enrollment, billing, and requirements for ongoing care responsibilities.

CICM Services

The Alliance is required to continue authorizing, providing, and paying for CICM services for all eligible members with UIS through Thursday, December 31, 2026. While CICM services will no longer be available to transitioned members in Medi-Cal FFS, Community Health Worker (CHW) services will continue to remain available to transitioned members after Friday, January 1, 2027. Since transitioned members in Medi-Cal FFS will no longer have access to CICM services, there may be increased needs for CHW services.

Steps CICM Service Providers Can Take to Start or Continue Serving Transitioning Members

This transition creates a significant opportunity for providers to begin serving Medi-Cal FFS members or to expand their existing participation.

Enrolling in Medi-Cal FFS

Interested providers must be enrolled in Medi-Cal FFS by Friday, January 1, 2027, to begin or continue serving Medi-Cal members transitioned to Medi-Cal FFS. In order to receive reimbursement at Medi-Cal FFS rates for services provided, unenrolled providers must complete an enrollment application with the DHCS Provider Enrollment Division (PED) through the Provider Application and Validation for Enrollment (PAVE) portal. For more information on PAVE enrollment, please visit www.dhcs.ca.gov/providers-partners/provider-application-and-validation-for-enrollment.

Providing Medi-Cal FFS Care Management Services

Certain care management, care coordination, or case management services, as well as CHW services, are available for coverage and reimbursement when billed in accordance with Medi-Cal coverage policy by eligible providers. Claims for CHW services must be submitted by an enrolled Medi-Cal supervising provider.

DHCS plans to provide links and/or a resource document that includes the available codes for billing purposes under Medi-Cal FFS. The resource will include lists of potential codes with links to the appropriate Provider Manual that includes details on billing guidance.

Becoming CHW Service Providers (for CICM Service Providers)

CHW services remain available in Medi-Cal FFS, and providers who meet all Medi-Cal provider requirements for an allowable supervising provider type, as outlined in Medi-Cal policy, may enroll to supervise and bill on behalf of CHWs for Medi-Cal FFS CHW services.

A supervising provider can only be a licensed provider; a hospital; an outpatient clinic as defined in 42 Code of Federal Regulations (CFR) section 440.90, which includes an Indian Health Services (IHS) Memorandum of Agreement (MOA) 638 Clinic and Tribal federally qualified health center (FQHC); a pharmacy; a community-based organization (CBO); or a local health jurisdiction (LHJ). However, non-tribal FQHCs and Rural Health Clinics (RHCs) cannot serve as supervising providers in Medi-Cal FFS.

For more information on becoming a CHW provider, please refer to the DHCS CHW website at www.dhcs.ca.gov/providers-partners/community-health-workers. Questions may be emailed to CHWBenefit@dhcs.ca.gov.

Requirements for CICM Provider Care Coordination with Transitioning Members Prior to Friday, January 1, 2027

CICM providers who have agreements with the Alliance, including Network Provider Agreements, Subcontractor Agreements, or Downstream Subcontractor Agreements, must conduct transition planning and care coordination for members with UIS prior to Friday, January 1, 2027.

Required activities include, but are not limited to:

  • CICM providers must coordinate with members’ PCPs, other care management service providers, behavioral health providers, county agencies, social service agencies, and community-based organizations to minimize disruptions in services prior to the transition.
  • CICM providers must verify whether members’ current providers can and are willing to continue to provide services in the Medi-Cal FFS delivery system. In instances that provider transition is needed, care management providers must identify alternative providers available to members post-transition within the Medi-Cal FFS delivery system using tools including, but not limited to, the DHCS Medi-Cal Fee-for-Service Provider Finder App by visiting dhcs.ca.gov/medi-cal/find-care.
  • CICM providers must also assess whether members may qualify for other available Medi-Cal FFS services, including Chronic Care Management, CHW services, behavioral health services, home and community-based services, county-based programs, or other supports available under Medi-Cal FFS or local delivery systems.
  • CICM providers must conduct warm handoffs of assessments and/or care plans to receiving Medi-Cal FFS providers and future care management providers whenever feasible.

Once new providers who will be receiving transitioning members are identified, current CICM providers must transmit member assessments and care management plans, ensuring compliance with all required data privacy and confidentiality safeguards, to the appropriate Medi-Cal FFS delivery system providers. If the receiving Medi-Cal FFS provider is able to accept a warm handoff, current and future care management providers must complete that handoff as soon as possible, but no later than Thursday, December 31, 2026. The receiving provider will not be able to receive reimbursement for the warm handoff. Receiving providers may start providing services and submit bills and claims to Medi-Cal FFS starting Friday, January 1, 2027, when those members have been transitioned to the Medi-Cal FFS delivery system.

Questions & Support

DHCS has provided the resources below for more information:

The Alliance will provide additional information as DHCS finalizes transition updates, including:

  • Updated billing codes for Medi-Cal FFS care management services;
  • Member support pathways; and
  • Contact information for DHCS or MCP support channels.

Sincerely,
Alameda Alliance for Health

Community Health Worker (CHW) Providers

October 28, 2026

Dear Provider,

At Alameda Alliance for Health (Alliance), we value our dedicated provider partner community. We have an important update we want to share with you.

Effective Friday, January 1, 2027, Medi-Cal managed care plan (MCP) members with unsatisfactory immigration status (UIS) will transition to the Medi-Cal Fee-for-Service (FFS) delivery system.

As further outlined in this document, Community Health Worker (CHW) service providers who have agreements with the Alliance (or its affiliated Dual Eligible Special Needs Plan [Alameda Alliance Wellness (HMO D-SNP)], as applicable), including Network Provider Agreements, Subcontractor Agreements, or Downstream Subcontractor Agreements, are required to actively support transitioning members to facilitate a smooth transition for providers and their patients. The California Department of Health Care Services (DHCS) is providing the following important information regarding provider enrollment, billing, and requirements for ongoing care responsibilities.

CHW Services

The Alliance is required to continue authorizing, providing, and paying for CHW services for all eligible members with UIS through Thursday, December 31, 2026. CHW services will continue to remain available to transitioned members after Friday, January 1, 2027.

Steps CHW Service Providers Can Take to Start or Continue Serving Transitioning Members

This transition creates a significant opportunity for providers to begin serving Medi-Cal FFS members or to expand their existing participation. There may be increased needs for CHW Services because members will no longer have access to services such as Enhanced Care Management (ECM) and Community Supports (CS).

Enrolling in Medi-Cal FFS

Interested providers must be enrolled in Medi-Cal FFS by Friday, January 1, 2027, to begin or continue serving Medi-Cal members transitioned to Medi-Cal FFS. In order to receive reimbursement at Medi-Cal FFS rates for services provided, unenrolled providers must complete an enrollment application with the DHCS Provider Enrollment Division (PED) through the Provider Application and Validation for Enrollment (PAVE) portal. For more information on PAVE enrollment, please visit www.dhcs.ca.gov/providers-partners/provider-application-and-validation-for-enrollment.

Providing Medi-Cal FFS Care Management Services

Certain care management, care coordination, or case management services, as well as CHW services, are available for coverage and reimbursement when billed in accordance with Medi-Cal coverage policy by eligible providers. Claims for CHW services must be submitted by an enrolled Medi-Cal supervising provider.

DHCS plans to provide links and/or a resource document that includes the available codes for billing purposes under Medi-Cal FFS. The resource will include lists of potential codes with links to the appropriate Provider Manual that includes details on billing guidance.

Becoming CHW Service Providers

CHW services remain available in Medi-Cal FFS, and providers who meet all Medi-Cal provider requirements for an allowable supervising provider type, as outlined in Medi-Cal policy, may enroll to supervise and bill on behalf of CHWs for Medi-Cal FFS CHW services.

A supervising provider can only be a licensed provider; a hospital; an outpatient clinic as defined in 42 Code of Federal Regulations (CFR) section 440.90, which includes an Indian Health Services (IHS) Memorandum of Agreement (MOA) 638 Clinic and Tribal federally qualified health center (FQHC); a pharmacy; a community-based organization (CBO); or a local health jurisdiction (LHJ). However, non-tribal FQHCs and Rural Health Clinics (RHCs) cannot serve as supervising providers in Medi-Cal FFS.

For more information on becoming a CHW provider, please refer to the DHCS CHW website at www.dhcs.ca.gov/providers-partners/community-health-workers. Questions may be emailed to CHWBenefit@dhcs.ca.gov.

Continue Serving Members Transitioning to Medi-Cal FFS

If you plan to continue providing CHW services to members who transition to Medi-Cal FFS beginning Friday, January 1, 2027, please take the following steps:

  1. Maintain your Medi-Cal FFS enrollment status or complete enrollment if you are not already enrolled.
  2. Review Medi-Cal FFS billing requirements for CHW services and ensure your organization has the processes in place to submit claims directly to DHCS.
  3. Become familiar with applicable CHW billing codes and reimbursement requirements outlined in the CHW Preventive Provider Manual at https://mcweb.apps.prd.cammis.medi-cal.ca.gov/assets/03BBA223-8762-4A94-A268-209510E15E37/chwprev.pdf?access_token=6UyVkRRfByXTZEWIh8j8QaYylPyP5ULO
  4. Submit claims to DHCS in accordance with Medi-Cal FFS billing policies to receive reimbursement for eligible CHW services provided to transitioned members.
  5. For more information, please refer to the DHCS CHW website at www.dhcs.ca.gov/providers-partners/community-health-workers.

Requirements for CHW Provider Care Coordination with Transitioning Members Prior to Friday, January 1, 2027

CHW providers who have agreements with the Alliance, including Network Provider Agreements, Subcontractor Agreements, or Downstream Subcontractor Agreements, must conduct transition planning and care coordination for members with UIS prior to Friday, January 1, 2027.

Required activities include, but are not limited to:

  • CHW providers must coordinate with members’ PCPs, other care management service providers, behavioral health providers, county agencies, social service agencies, and community-based organizations to minimize disruptions in services prior to the transition.
  • CHW providers must verify whether members’ current providers can and are willing to continue to provide services in the Medi-Cal FFS delivery system. In instances that provider transition is needed, care management providers must identify alternative providers available to members post-transition within the Medi-Cal FFS delivery system using tools including, but not limited to, the DHCS Medi-Cal Fee-for-Service Provider Finder App by visiting dhcs.ca.gov/medi-cal/find-care.
  • CHW providers must also assess whether members may qualify for other available Medi-Cal FFS services, including Chronic Care Management, behavioral health services, home and community-based services, county-based programs, or other supports available under Medi-Cal FFS or local delivery systems.

Once new providers who will be receiving transitioning members are identified, current CHW providers must transmit member assessments and care management plans, ensuring compliance with all required data privacy and confidentiality safeguards, to the appropriate Medi-Cal FFS delivery system providers. If the receiving Medi-Cal FFS provider is able to accept a warm handoff, current and future care management providers must complete that handoff as soon as possible, but no later than Thursday, December 31, 2026. The receiving provider will not be able to receive reimbursement for the warm handoff. Receiving providers may start providing services and submit bills and claims to Medi-Cal FFS starting Friday, January 1, 2027, when those members have been transitioned to the Medi-Cal FFS delivery system.

Questions & Support

DHCS has provided the resources below for more information:

The Alliance will provide additional information as DHCS finalizes transition updates, including:

  • Updated billing codes for Medi-Cal FFS care management services;
  • Member support pathways; and
  • Contact information for DHCS or MCP support channels.

Sincerely,
Alameda Alliance for Health

Community Supports (CS) Providers

October 28, 2026

Dear Provider,

At Alameda Alliance for Health (Alliance), we value our dedicated provider partner community. We have an important update we want to share with you.

Effective Friday, January 1, 2027, Medi-Cal managed care plan (MCP) members with unsatisfactory immigration status (UIS) will transition to the Medi-Cal Fee-for-Service (FFS) delivery system.

As further outlined in this document, Community Supports (CS) providers who have agreements with the Alliance (or its affiliated Dual Eligible Special Needs Plan [Alameda Alliance Wellness (HMO D-SNP)], as applicable), including Network Provider Agreements, Subcontractor Agreements, or Downstream Subcontractor Agreements, are required to actively support transitioning members to facilitate a smooth transition for providers and their patients. The California Department of Health Care Services (DHCS) is providing the following important information regarding provider enrollment, billing, and requirements for ongoing care responsibilities.

CS Services

The Alliance is required to continue authorizing, providing, and paying for CS services for all eligible members with UIS through Thursday, December 31, 2026. While CS services will no longer be available to transitioned members in Medi-Cal FFS, Community Health Worker (CHW) services will continue to remain available to transitioned members after Friday, January 1, 2027. Since transitioned members in Medi-Cal FFS will no longer have access to CS services, there may be increased needs for CHW services.

Steps Providers of CS Services Can Take to Start or Continue Serving Transitioning Members

This transition creates a significant opportunity for providers to begin serving Medi-Cal FFS members or to expand their existing participation.

Enrolling in Medi-Cal FFS

Interested providers must be enrolled in Medi-Cal FFS by Friday, January 1, 2027, to begin or continue serving Medi-Cal members transitioned to Medi-Cal FFS. In order to receive reimbursement at Medi-Cal FFS rates for services provided, unenrolled providers must complete an enrollment application with the DHCS Provider Enrollment Division (PED) through the Provider Application and Validation for Enrollment (PAVE) portal. For more information on PAVE enrollment, please visit www.dhcs.ca.gov/providers-partners/provider-application-and-validation-for-enrollment.

Providing Medi-Cal FFS Care Management Services

Certain care management, care coordination, or case management services, as well as CHW services, are available for coverage and reimbursement when billed in accordance with Medi-Cal coverage policy by eligible providers. Claims for CHW services must be submitted by an enrolled Medi-Cal supervising provider.

DHCS plans to provide links and/or a resource document that includes the available codes for billing purposes under Medi-Cal FFS. The resource will include lists of potential codes with links to the appropriate Provider Manual that includes details on billing guidance.

Becoming CHW Service Providers (for CS Service Providers)

CHW services remain available in Medi-Cal FFS, and providers who meet all Medi-Cal provider requirements for an allowable supervising provider type, as outlined in Medi-Cal policy, may enroll to supervise and bill on behalf of CHWs for Medi-Cal FFS CHW services.

A supervising provider can only be a licensed provider; a hospital; an outpatient clinic as defined in 42 Code of Federal Regulations (CFR) section 440.90, which includes an Indian Health Services (IHS) Memorandum of Agreement (MOA) 638 Clinic and Tribal federally qualified health center (FQHC); a pharmacy; a community-based organization (CBO); or a local health jurisdiction (LHJ). However, non-tribal FQHCs and Rural Health Clinics (RHCs) cannot serve as supervising providers in Medi-Cal FFS.

For more information on becoming a CHW provider, please refer to the DHCS CHW website at www.dhcs.ca.gov/providers-partners/community-health-workers. Questions may be emailed to CHWBenefit@dhcs.ca.gov.

Requirements for CS Providers with Transitioning Members Prior to Friday, January 1, 2027

CHW providers who have agreements with the Alliance, including Network Provider Agreements, Subcontractor Agreements, or Downstream Subcontractor Agreements, must conduct transition planning and care coordination for members with UIS prior to Friday, January 1, 2027.

Required activities include, but are not limited to:

  • CS providers must coordinate with members’ PCPs, other care management service providers, behavioral health providers, county agencies, social service agencies, and community-based organizations to minimize disruptions in services prior to the transition.
  • CS providers must verify whether members’ current providers can and are willing to continue to provide services in the Medi-Cal FFS delivery system. In instances that provider transition is needed, care management providers must identify alternative providers available to members post-transition within the Medi-Cal FFS delivery system using tools including, but not limited to, the DHCS Medi-Cal Fee-for-Service Provider Finder App by visiting dhcs.ca.gov/medi-cal/find-care.
  • CS providers must also assess whether members may qualify for other available Medi-Cal FFS services, including Chronic Care Management, CHW services, behavioral health services, home and community-based services, county-based programs, or other supports available under Medi-Cal FFS or local delivery systems.
  • CS providers must conduct warm handoffs of assessments and/or care plans to receiving Medi-Cal FFS providers and future care management providers whenever feasible.

Once new providers who will be receiving transitioning members are identified, current CS providers must transmit member assessments and care management plans, ensuring compliance with all required data privacy and confidentiality safeguards, to the appropriate Medi-Cal FFS delivery system providers. If the receiving Medi-Cal FFS provider is able to accept a warm handoff, current and future care management providers must complete that handoff as soon as possible, but no later than Thursday, December 31, 2026. The receiving provider will not be able to receive reimbursement for the warm handoff. Receiving providers may start providing services and submit bills and claims to Medi-Cal FFS starting Friday, January 1, 2027, when those members have been transitioned to the Medi-Cal FFS delivery system.

Questions & Support

DHCS has provided the resources below for more information:

The Alliance will provide additional information as DHCS finalizes transition updates, including:

  • Updated billing codes for Medi-Cal FFS care management services;
  • Member support pathways; and
  • Contact information for DHCS or MCP support channels.

Sincerely,
Alameda Alliance for Health

Enhanced Care Management (ECM) Providers

October 28, 2026

Dear Provider,

At Alameda Alliance for Health (Alliance), we value our dedicated provider partner community. We have an important update we want to share with you.

Effective Friday, January 1, 2027, Medi-Cal managed care plan (MCP) members with unsatisfactory immigration status (UIS) will transition to the Medi-Cal Fee-for-Service (FFS) delivery system.

As further outlined in this document, Enhanced Care Management (ECM) providers who have agreements with the Alliance (or its affiliated Dual Eligible Special Needs Plan [Alameda Alliance Wellness (HMO D-SNP)], as applicable), including Network Provider Agreements, Subcontractor Agreements, or Downstream Subcontractor Agreements, are required to actively support transitioning members to facilitate a smooth transition for providers and their patients. The California Department of Health Care Services (DHCS) is providing the following important information regarding provider enrollment, billing, and requirements for ongoing care responsibilities.

ECM Services

The Alliance is required to continue authorizing, providing, and paying for ECM services for all eligible members with UIS through Thursday, December 31, 2026. While ECM services will no longer be available to transitioned members in Medi-Cal FFS, Community Health Worker (CHW) services will continue to remain available to transitioned members after Friday, January 1, 2027. Since transitioned members in Medi-Cal FFS will no longer have access to ECM services, there may be increased needs for CHW services.

Steps ECM Service Providers Can Take to Start or Continue Serving Transitioning Members

This transition creates a significant opportunity for providers to begin serving Medi-Cal FFS members or to expand their existing participation.

Enrolling in Medi-Cal FFS

Interested providers must be enrolled in Medi-Cal FFS by Friday, January 1, 2027, to begin or continue serving Medi-Cal members transitioned to Medi-Cal FFS. In order to receive reimbursement at Medi-Cal FFS rates for services provided, unenrolled providers must complete an enrollment application with the DHCS Provider Enrollment Division (PED) through the Provider Application and Validation for Enrollment (PAVE) portal. For more information on PAVE enrollment, please visit www.dhcs.ca.gov/providers-partners/provider-application-and-validation-for-enrollment.

Providing Medi-Cal FFS Care Management Services

Certain care management, care coordination, or case management services, as well as CHW services, are available for coverage and reimbursement when billed in accordance with Medi-Cal coverage policy by eligible providers. Claims for CHW services must be submitted by an enrolled Medi-Cal supervising provider.

DHCS plans to provide links and/or a resource document that includes the available codes for billing purposes under Medi-Cal FFS. The resource will include lists of potential codes with links to the appropriate Provider Manual that includes details on billing guidance.

Becoming CHW Service Providers (for ECM Service Providers)

CHW services remain available in Medi-Cal FFS, and providers who meet all Medi-Cal provider requirements for an allowable supervising provider type, as outlined in Medi-Cal policy, may enroll to supervise and bill on behalf of CHWs for Medi-Cal FFS CHW services.

A supervising provider can only be a licensed provider; a hospital; an outpatient clinic as defined in 42 Code of Federal Regulations (CFR) section 440.90, which includes an Indian Health Services (IHS) Memorandum of Agreement (MOA) 638 Clinic and Tribal federally qualified health center (FQHC); a pharmacy; a community-based organization (CBO); or a local health jurisdiction (LHJ). However, non-tribal FQHCs and Rural Health Clinics (RHCs) cannot serve as supervising providers in Medi-Cal FFS.

For more information on becoming a CHW provider, please refer to the DHCS CHW website at www.dhcs.ca.gov/providers-partners/community-health-workers. Questions may be emailed to CHWBenefit@dhcs.ca.gov.

Requirements for ECM Provider Care Coordination with Transitioning Members Prior to Friday, January 1, 2027

ECM providers who have agreements with the Alliance, including Network Provider Agreements, Subcontractor Agreements, or Downstream Subcontractor Agreements, must conduct transition planning and care coordination for members with UIS prior to Friday, January 1, 2027.

Required activities include, but are not limited to:

  • ECM providers must coordinate with members’ PCPs, other care management service providers, behavioral health providers, county agencies, social service agencies, and community-based organizations to minimize disruptions in services prior to the transition.
  • ECM providers must verify whether members’ current providers can and are willing to continue to provide services in the Medi-Cal FFS delivery system. In instances that provider transition is needed, care management providers must identify alternative providers available to members post-transition within the Medi-Cal FFS delivery system using tools including, but not limited to, the DHCS Medi-Cal Fee-for-Service Provider Finder App by visiting dhcs.ca.gov/medi-cal/find-care.
  • ECM providers must also assess whether members may qualify for other available Medi-Cal FFS services, including Chronic Care Management, CHW services, behavioral health services, home and community-based services, county-based programs, or other supports available under Medi-Cal FFS or local delivery systems.
  • ECM providers must conduct warm handoffs of assessments and/or care plans to receiving Medi-Cal FFS providers and future care management providers whenever feasible.

Once new providers who will be receiving transitioning members are identified, current ECM providers must transmit member assessments and care management plans, ensuring compliance with all required data privacy and confidentiality safeguards, to the appropriate Medi-Cal FFS delivery system providers. If the receiving Medi-Cal FFS provider is able to accept a warm handoff, current and future care management providers must complete that handoff as soon as possible, but no later than Thursday, December 31, 2026. The receiving provider will not be able to receive reimbursement for the warm handoff. Receiving providers may start providing services and submit bills and claims to Medi-Cal FFS starting Friday, January 1, 2027, when those members have been transitioned to the Medi-Cal FFS delivery system.

Questions & Support

DHCS has provided the resources below for more information:

The Alliance will provide additional information as DHCS finalizes transition updates, including:

  • Updated billing codes for Medi-Cal FFS care management services;
  • Member support pathways; and
  • Contact information for DHCS or MCP support channels.

Sincerely,
Alameda Alliance for Health

Long-Term Care (LTC) Providers

October 28, 2026

Dear Provider,

At Alameda Alliance for Health (Alliance), we value our dedicated provider partner community. We have an important update we want to share with you.

Effective Friday, January 1, 2027, Medi-Cal managed care plan (MCP) members with unsatisfactory immigration status (UIS) will transition to the Medi-Cal Fee-for-Service (FFS) delivery system.

As further outlined in this document, Long-Term Care (LTC) Facilities (including Skilled Nursing Facilities (SNF), Subacute, and Intermediate Care Facility for Developmentally Disabled (ICF-DD)) that have agreements with the Alliance (or its affiliated Dual Eligible Special Needs Plan [Alameda Alliance Wellness (HMO D-SNP)], as applicable), including Network Provider Agreements, Subcontractor Agreements, or Downstream Subcontractor Agreements, are required to actively support transitioning Members to facilitate a smooth transition for providers and their patients. The California Department of Health Care Services (DHCS) is providing the following important information regarding provider enrollment, billing, and requirements for ongoing care responsibilities.

LTC Services

The Alliance is required to continue authorizing, providing, and paying for LTC services for all eligible members with UIS through Thursday, December 31, 2026. LTC services will continue to remain available to transitioned members after Friday, January 1, 2027.

Please note: Federal law prohibits facilities from transferring or discharging Medi-Cal members due to a change in the member’s insurance coverage, such as from managed care to Medi-Cal FFS.

Requirements for LTC Facility Care Coordination with Transitioning Members Prior to Friday, January 1, 2027

LTC Facilities that have agreements with the Alliance, including Network Provider Agreements, Subcontractor Agreements, or Downstream Subcontractor Agreements, must conduct transition planning and care coordination for members with UIS prior to Friday, January 1, 2027.

Required activities include, but are not limited to:

  • LTC facilities must coordinate with members’ PCPs, other care management service providers, behavioral health providers, county agencies, social service agencies, and community-based organizations to minimize disruptions in services prior to the transition.
  • LTC facilities must verify whether members’ current providers can and are willing to continue to provide services in the Medi-Cal FFS delivery system. In instances that provider transition is needed, CCS providers must identify alternative providers available to members post-transition within the Medi-Cal FFS delivery system using tools including, but not limited to, the DHCS Medi-Cal Fee-for-Service Provider Finder App by visiting dhcs.ca.gov/medi-cal/find-care.
  • LTC facilities must also assess whether members may qualify for other available Medi-Cal FFS services, including Chronic Care Management, behavioral health services, home and community-based services, county-based programs, or other supports available under Medi-Cal FFS or local delivery systems.

Once new providers who will be receiving transitioning members are identified, current LTC providers must transmit member assessments and care management plans, ensuring compliance with all required data privacy and confidentiality safeguards, to the appropriate Medi-Cal FFS delivery system providers. Receiving providers may start providing services and submit bills and claims to Medi-Cal FFS starting Friday, January 1, 2027, when those members have been transitioned to the Medi-Cal FFS delivery system.

Questions & Support

DHCS has provided the resources below for more information:

The Alliance will provide additional information as DHCS finalizes transition updates, including:

  • Updated billing codes for Medi-Cal FFS care management services;
  • Member support pathways; and
  • Contact information for DHCS or MCP support channels.

Sincerely,
Alameda Alliance for Health

Primary Care Providers (PCP)

October 28, 2026

Dear Provider,

At Alameda Alliance for Health (Alliance), we value our dedicated provider partner community. We have an important update we want to share with you.

Effective Friday, January 1, 2027, Medi-Cal managed care plan (MCP) members with unsatisfactory immigration status (UIS) will transition to the Medi-Cal Fee-for-Service (FFS) delivery system.

As further outlined in this document, primary care providers (PCPs), including Federally Qualified Health Centers (FQHCs), that have agreements with the Alliance (or its affiliated Dual Eligible Special Needs Plan [Alameda Alliance Wellness (HMO D-SNP)], as applicable), including Network Provider Agreements, Subcontractor Agreements, or Downstream Subcontractor Agreements, are required to actively support transitioning Members to facilitate a smooth transition for providers and their patients. The California Department of Health Care Services (DHCS) is providing the following important information regarding provider enrollment, billing, and requirements for ongoing care responsibilities.

PCP Services

The Alliance will continue to accept referrals and authorize covered services through Thursday, December 31, 2026.

Please note: For services that are expected to:

  • Start after Thursday, October 1, 2026, and continue after Friday, January 1, 2027, or
  • Start Friday, January 1, 2027

DHCS requests that the referrals made by PCPs from Thursday, October 1, 2026, to Thursday, December 31, 2026, be made to Alliance providers who are also enrolled in Medi-Cal FFS, when possible, to minimize disruptions to member care and promote continuity of provider access. This includes referrals to specialists, behavioral health providers, durable medical equipment (DME) providers, home health agencies, and other providers that may be involved in a member’s ongoing course of treatment.

Steps PCPs Can Take to Start or Continue Serving Transitioning Members

This transition creates a significant opportunity for providers to begin serving Medi-Cal FFS members or to expand their existing participation.

Enrolling in Medi-Cal FFS

Interested providers must be enrolled in Medi-Cal FFS by Friday, January 1, 2027, to begin or continue serving Medi-Cal members transitioned to Medi-Cal FFS. In order to receive reimbursement at Medi-Cal FFS rates for services provided, unenrolled providers must complete an enrollment application with the DHCS Provider Enrollment Division (PED) through the Provider Application and Validation for Enrollment (PAVE) portal. For more information on PAVE enrollment, please visit www.dhcs.ca.gov/providers-partners/provider-application-and-validation-for-enrollment.

Medi-Cal FFS Billing

DHCS strongly encourages all providers to familiarize themselves with Medi-Cal FFS billing processes to prepare for billing Medi-Cal FFS after Friday, January 1, 2027.

This includes:

Medi-Cal providers have access to billing and claims assistance through DHCS’ California Medicaid Management Information System (CA-MMIS) and its contracted Fiscal Intermediary (FI). CA-MMIS and FI staff can assist providers with questions about paper claim submissions, electronic claim submissions, and Treatment Authorization Requests (TARs) and electronic TARs (eTARs).

Medi-Cal providers can also contact the Telephone Service Center (TSC) toll-free at 1.800.541.5555 (outside of California, 1.916.636.1980), Monday through Friday, except holidays, from 8 am – 5 pm. For faster access to TSC resources, Medi-Cal providers can refer to the TSC Main Menu Prompt Options Guide at https://mcweb.apps.prd.cammis.medi-cal.ca.gov/assets/82E2E926-5998-44E3-A478-965E0B59FFE8/provrelfrm1ref.pdf?access_token=6UyVkRRfByXTZEWIh8j8QaYylPyP5ULO.

While certain care management services, such as Enhanced Care Management (ECM) and Community Supports (CS), are not covered under Medi-Cal FFS, certain care management, care coordination, or case management services, as well as Community Health Worker (CHW) services, are available for coverage and reimbursement when billed in accordance with Medi-Cal coverage policy by eligible providers. Specifically, providers enrolled in Medi-Cal FFS may bill for eligible care management, case management, or care coordination activities using existing Medi-Cal FFS billing codes to receive reimbursement for case management and care management functions.

Claims for CHW services must be submitted by an enrolled Medi-Cal supervising provider.

DHCS plans to provide links and/or a resource document that includes the available codes for billing purposes under Medi-Cal FFS. The resource will include lists of potential codes, such as the ones listed in this letter, with links to the appropriate Provider Manual that includes details on billing guidance.

Requirements for PCP Care Coordination with Transitioning Members Prior to Friday, January 1, 2027

PCPs who have agreements with the Alliance, including Network Provider Agreements, Subcontractor Agreements, or Downstream Subcontractor Agreements, must conduct transition planning and care coordination for members with UIS prior to Friday, January 1, 2027.

Required activities include, but are not limited to:

  • PCPs must coordinate with members’ PCPs, other care management service providers, behavioral health providers, county agencies, social service agencies, and community-based organizations to minimize disruptions in services prior to the transition.
  • PCPs must verify whether members’ current providers can and are willing to continue to provide services in the Medi-Cal FFS delivery system. In instances that provider transition is needed, care management providers must identify alternative providers available to members post-transition within the Medi-Cal FFS delivery system using tools including, but not limited to, the DHCS Medi-Cal Fee-for-Service Provider Finder App by visiting dhcs.ca.gov/medi-cal/find-care.
  • PCPs must also assess whether members may qualify for other available Medi-Cal FFS services, including Chronic Care Management, behavioral health services, home and community-based services, county-based programs, or other supports available under Medi-Cal FFS or local delivery systems.
  • PCPs are encouraged to remind members to maintain established appointments and obtain medication refills before Friday, January 1, 2027, to avoid disruptions.
  • PCPs should encourage transitioning members to access more information on the DHCS website at dhcs.ca.gov/medi-cal/updates/fee-for-service-transition.

Once new providers who will be receiving transitioning members are identified, current PCPs must transmit member assessments and care management plans, ensuring compliance with all required data privacy and confidentiality safeguards, to the appropriate Medi-Cal FFS delivery system providers. If the receiving Medi-Cal FFS provider is able to accept a warm handoff, PCPs must complete that handoff as soon as possible, but no later than Thursday, December 31, 2026. The receiving provider will not be able to receive reimbursement for the warm handoff. Receiving providers may start providing services and submit bills and claims to Medi-Cal FFS starting Friday, January 1, 2027, when those members have been transitioned to the Medi-Cal FFS delivery system.

Not Continuing to Serve a Member Who Transitions to Medi-Cal FFS 

If you are not planning to continue to care for a member who transitions to Medi-Cal FFS, please ensure that a handoff with appropriate records is shared with your colleague who will continue to care for these patients. A list of providers who are enrolled in Medi-Cal FFS can be found at https://data.chhs.ca.gov/dataset/profile-of-enrolled-medi-cal-fee-for-service-ffs-providers.

Questions & Support

DHCS has provided the resources below for more information:

The Alliance will provide additional information as DHCS finalizes transition updates, including:

  • Updated billing codes for Medi-Cal FFS care management services;
  • Member support pathways; and
  • Contact information for DHCS or MCP support channels.

Sincerely,
Alameda Alliance for Health

Transitional Care Services (TCS) Providers

October 28, 2026

Dear Provider,

At Alameda Alliance for Health (Alliance), we value our dedicated provider partner community. We have an important update we want to share with you.

Effective Friday, January 1, 2027, Medi-Cal managed care plan (MCP) members with unsatisfactory immigration status (UIS) will transition to the Medi-Cal Fee-for-Service (FFS) delivery system.

As further outlined in this document, Transitional Care Services (TCS) providers who have agreements with the Alliance, including Network Provider Agreements, Subcontractor Agreements, or Downstream Subcontractor Agreements, are required to actively support transitioning members to facilitate a smooth transition for providers and their patients. The California Department of Health Care Services (DHCS) is providing the following important information regarding provider enrollment, billing, and requirements for ongoing care responsibilities.

TCS

The Alliance is required to continue authorizing, providing, and paying for TCS for all eligible members with UIS through Thursday, December 31, 2026. While TCS will no longer be available to transitioned members in Medi-Cal FFS, Community Health Worker (CHW) services will continue to remain available to transitioned members after Friday, January 1, 2027. Since transitioned members in Medi-Cal FFS will no longer have access to TCS, there may be increased needs for CHW services.

Steps TCS Providers Can Take to Start or Continue Serving Transitioning Members

This transition creates a significant opportunity for providers to begin serving Medi-Cal FFS members or to expand their existing participation.

Enrolling in Medi-Cal FFS

Interested providers must be enrolled in Medi-Cal FFS by Friday, January 1, 2027, to begin or continue serving Medi-Cal members transitioned to Medi-Cal FFS. In order to receive reimbursement at Medi-Cal FFS rates for services provided, unenrolled providers must complete an enrollment application with the DHCS Provider Enrollment Division (PED) through the Provider Application and Validation for Enrollment (PAVE) portal. For more information on PAVE enrollment, please visit www.dhcs.ca.gov/providers-partners/provider-application-and-validation-for-enrollment.

Providing Medi-Cal FFS Care Management Services

Certain care management, care coordination, or case management services, as well as CHW services, are available for coverage and reimbursement when billed in accordance with Medi-Cal coverage policy by eligible providers. Claims for CHW services must be submitted by an enrolled Medi-Cal supervising provider.

DHCS plans to provide links and/or a resource document that includes the available codes for billing purposes under Medi-Cal FFS. The resource will include lists of potential codes with links to the appropriate Provider Manual that includes details on billing guidance.

Becoming CHW Service Providers (for TCS Providers)

CHW services remain available in Medi-Cal FFS, and providers who meet all Medi-Cal provider requirements for an allowable supervising provider type, as outlined in Medi-Cal policy, may enroll to supervise and bill on behalf of CHWs for Medi-Cal FFS CHW services.

A supervising provider can only be a licensed provider; a hospital; an outpatient clinic as defined in 42 Code of Federal Regulations (CFR) section 440.90, which includes an Indian Health Services (IHS) Memorandum of Agreement (MOA) 638 Clinic and Tribal federally qualified health center (FQHC); a pharmacy; a community-based organization (CBO); or a local health jurisdiction (LHJ). However, non-tribal FQHCs and Rural Health Clinics (RHCs) cannot serve as supervising providers in Medi-Cal FFS.

For more information on becoming a CHW provider, please refer to the DHCS CHW website at www.dhcs.ca.gov/providers-partners/community-health-workers. Questions may be emailed to CHWBenefit@dhcs.ca.gov.

Requirements for TCS Provider Care Coordination with Transitioning Members Prior to Friday, January 1, 2027

TCS providers who have agreements with the Alliance, including Network Provider Agreements, Subcontractor Agreements, or Downstream Subcontractor Agreements, must conduct transition planning and care coordination for members with UIS prior to Friday, January 1, 2027.

Required activities include, but are not limited to:

  • TCS providers must coordinate with members’ PCPs, other care management service providers, behavioral health providers, county agencies, social service agencies, and community-based organizations to minimize disruptions in services prior to the transition.
  • TCS providers must verify whether members’ current providers can and are willing to continue to provide services in the Medi-Cal FFS delivery system. In instances that provider transition is needed, care management providers must identify alternative providers available to members post-transition within the Medi-Cal FFS delivery system using tools including, but not limited to, the DHCS Medi-Cal Fee-for-Service Provider Finder App by visiting dhcs.ca.gov/medi-cal/find-care.
  • TCS providers must also assess whether members may qualify for other available Medi-Cal FFS services, including Chronic Care Management, CHW services, behavioral health services, home and community-based services, county-based programs, or other supports available under Medi-Cal FFS or local delivery systems.
  • TCS providers must conduct warm handoffs of assessments and/or care plans to receiving Medi-Cal FFS providers and future care management providers whenever feasible.

Once new providers who will be receiving transitioning members are identified, current TCS providers must transmit member assessments and care management plans, ensuring compliance with all required data privacy and confidentiality safeguards, to the appropriate Medi-Cal FFS delivery system providers. If the receiving Medi-Cal FFS provider is able to accept a warm handoff, current and future care management providers must complete that handoff as soon as possible, but no later than Thursday, December 31, 2026. The receiving provider will not be able to receive reimbursement for the warm handoff. Receiving providers may start providing services and submit bills and claims to Medi-Cal FFS starting Friday, January 1, 2027, when those members have been transitioned to the Medi-Cal FFS delivery system.

Questions & Support

DHCS has provided the resources below for more information:

The Alliance will provide additional information as DHCS finalizes transition updates, including:

  • Updated billing codes for Medi-Cal FFS care management services;
  • Member support pathways; and
  • Contact information for DHCS or MCP support channels.

Sincerely,
Alameda Alliance for Health