MedicaidDocumentationHigh impact
25-1115 Hospice Documentation Deadlines Enforced Starting January 8, 2026
Health Net·CA · Palliative Care, Family Medicine, Internal Medicine +1 more·Prior Authorization
Effective date
Jan 8, 2026
We identified it
Jun 20, 2026
Summary
Starting January 8, 2026, CalViva Health will strictly enforce a 5-calendar-day deadline for submitting all required hospice documentation after hospice election. Services will not be reimbursed for any dates prior to receipt of complete documentation, and coverage is now limited to in-network hospice providers unless medically necessary services are unavailable in-network.
Action Required
Before January 8, 2026: Billing team must update workflows to ensure all hospice documentation is submitted within 5 calendar days of hospice election. Download and review the 'Hospice Services Documentation Guide' from Provider Library > Forms and References. For outpatient hospice, send documentation via encrypted email to Hospice CTI forms. For inpatient hospice, attach all required documentation to prior authorization requests. Verify all hospice providers are in-network before services begin. Failure to meet the 5-day deadline will result in denial of reimbursement from admission date until documentation is complete.