Provider Notifications/Updates


Timely Access Regulations and Upcoming Surveys
Important Information for Physician Practices

Provider Online Interface Form Flyer
Effective July 1, 2016, contracted providers are required to notify Care1st within 5 business days of any changes to their panel status pursuant to H&S 1367.27. Care1st contracted providers can review their information through a Provider Data Form located in the Provider Portal. More

SB 75 – Full Scope Medi-Cal for All Children

  • The Department of Health Care Services (DHCS) will implement the transition of individuals from restricted scope to full scope Medi-Cal coverage by May 1, 2016.

DHCS recognizes SB 75 affects two (2) populations of children:

  • Transition population - individuals under age 19 who are currently enrolled into restricted scope Medi-Cal with unsatisfactory immigration status; and,
  • New enrollee population - individuals under age 19 who are eligible for Medi-Cal and have unsatisfactory immigration status not yet enrolled

DCHS has not created aids codes for the transition of the two (2) populations.

Care1st Enrollment Unit is available M-F from 8am-6pm and be reached at (866) 820-6009 for assistance with the following:

  • SB 75 education
  • Enrollment assistance into the Medi-Cal program
  • Enrollment assistance into Medi-Cal Managed Care
  • Adding a family member to an existing case
  • Medi-Cal Annual Re-determination
  • Reinstate Medi-cal benefits assistance


ICD 10 Implementation
  • On July 31, 2014, the Centers for Medicare & Medicaid Services (CMS) released a final rule that will require ICD-10 to be implemented on October 1, 2015, and that will require HIPAA-covered entities to continue to use ICD-9 until September 30, 2015. All HIPAA covered entities must be able to successfully submit transactions on or after October 1, 2015, using the ICD-10 diagnosis and procedure codes. Care1st is ready to accept ICD-10 for outpatient services on or after October 1, 2105 and inpatient dates of discharge on or after October 1, 2015. More
  • Important Notice Regarding Claims for Members with Care1st's Coordinated Choice Plan. Recent changes to California Law have changed the rules for persons with Medicare and Medi-Cal (Medi-Medi) who wish to enroll in a Dual Eligible Special Needs Plan (DSNP). More
Antidepressant Medication Management
  • While depression is the most common behavioral health condition affecting adults, it is also one of the most treatable. The National Committee for Quality Assurance (NCQA) has established two measures to monitor medication compliance for patients with depression who are prescribed antidepressant medication. More...
  • State of California's Medi-Cal Expansion - Mental Health Services - Effective January 1, 2014
    Care1st Health Plan is pleased to participate in the State of California's Medi-Cal Expansion that starts January 1, 2014 and enhances outpatient mental health services. Beginning January 1, 2014, Care1st Health Plan will be responsible for the delivery of certain mental health services for Care1st Medi-Cal members with mild to moderate impairment of mental, emotional, or behavioral functioning.

Provider Roster:
  • Los Angeles/ San Diego Counties – Medi-Cal Mental Health Services Expansion
    Effective 1/1/2014 – Beacon Provider Roster - [Coming soon]

  • Benefits of Electronic fund Transfer (EFT) Include:
    Care1st Health Plan has teamed up with J.P. Morgan to speed up claims payment via an electronic fund transfer (EFT) system. Your business provides services to our members so it is our top priority that you have fast access to your money and easy claim processing for your office. More