MedicaidDocumentationMedium impact
26-748 CalAIM PHM Update: New Requirements for Pregnancy Care, IHAs and Care Coordination
Health Net·CA · OB-GYN, Family Medicine, Internal Medicine·Pharmacy
Effective date
Jul 1, 2026
We identified it
Jun 20, 2026
Summary
Health Net California updated care coordination requirements for pregnant and postpartum patients under CalAIM Population Health Management policy. Starting July 1, 2026, all pregnancy/postpartum care must use moderate or high-intensity care coordination with mandatory risk assessments and birthing supports checklists.
Action Required
Through June 30, 2026: Respond promptly to Health Net outreach requests, fax discharge information to 844-989-1935 (do not mail), complete and document follow-up visits for postpartum and primary care, submit IHA results within 90 days of enrollment, and document IHA exceptions when using prior records. By July 1, 2026: OB-GYN providers must implement ACOG/CPSP-standard risk assessments for all pregnant patients at early prenatal visit, each trimester, and postpartum visit. Develop individualized care plans including obstetric, nutrition, psychosocial and health education interventions. Complete birthing supports checklist to connect patients to medical, behavioral health and social supports.