2027 Medi-Cal Fee-For-Service Transition
Effective January 1, 2027, certain Medi-Cal members with Unsatisfactory Immigration Status (UIS) will transition from Medi-Cal managed care through the Alliance to Medi-Cal Fee-for-Service (FFS), as required by federal guidance. Members may generally receive covered services from any provider who is enrolled in Medi-Cal FFS and accepting new patients.
We encourage you to keep serving impacted members. Please review the following resources to understand how the changes impact Medi-Cal providers and members, and how you can prepare for the transition.
这对供应商意味着什么
Beginning January 1, 2027, you must be enrolled as a Medi-Cal FFS provider to bill Medi-Cal FFS for services provided to impacted members. 对于受影响成员在 2026 年 12 月 31 日之后提供的任何服务，联盟将不承担支付责任。.
For any services provided to Medi-Cal FFS members, providers must:
- Follow state FFS requirements for claims and service authorization.
- Verify eligibility and coverage for each date of service.
Note: FFS reimbursement follows state Medi-Cal payment methodologies and may differ from Alliance contract rates.
How providers should prepare
访问 DHCS Transition to Medi-Cal Fee-for-Service page for an overview of the transition and links to provider and member resources.
Verify that you are enrolled in Medi-Cal FFS through the Provider Application and Validation for Enrollment （铺平） system.
- If you are already enrolled: No additional enrollment is required. You may continue providing services to these members and receive reimbursement under Medi-Cal FFS. You will need to bill Medi-Cal FFS in order to be paid for services to these members.
- If you are not enrolled, 你必须：
- Submit a Medi-Cal FFS provider enrollment application through the DHCS Provider Enrollment Division (PED).
- 在 2027 年 1 月 1 日之前获得注册批准，即可获得为过渡成员提供的服务的报销。.
- Help patients understand how to access services through Medi-Cal FFS. You can share these resources with Medi-Cal members:
- Fee-For-Service webpage for Alliance members: Explains which members will see changes and how to get care.
- DHCS Fee-For-Service Transition page: Clear, plain-language information for affected members, including what is changing, what stays the same and steps they may need to take.
- Support continuity of medically necessary care whenever possible. If you are unable to continue caring for impacted members, please ensure a timely transfer of care by coordinating with the receiving provider and transferring the member’s medical records.
- Review members’ current medications. 西hen clinically appropriate, ensure members have an adequate supply of their prescriptions before January 1, 2027. This can help prevent potential delays or interruptions in medication access as members transition from Medi-Cal managed care to Medi-Cal Fee-for-Service (FFS).
更多资源
如有任何疑问，请联系您的供应商关系代表。.
