California DHCS Launches FQHC Billing Compliance Review Initiative
The California Department of Health Care Services announced a targeted billing compliance review for 50 FQHCs in 2026, focusing on PPS encounter documentation, Medi-Cal managed care billing accuracy, and UIS patient service tracking ahead of the July 2026 PPS elimination for UIS patients. FQHCs must ensure documentation standards meet both HRSA and DHCS requirements. Reviews will examine 24 months of billing data with particular attention to ECM and Community Supports claims.
Key takeaways
- DHCS targeting 50 FQHCs for billing compliance review in 2026
- Focus: PPS encounter documentation, Medi-Cal billing accuracy, UIS patient tracking before Jul 2026 PPS elimination
- Reviews will examine 24 months of billing data with focus on ECM/Community Supports claims
Primary source
California DHCSFQHC Talent. (2026, February 10). California DHCS Launches FQHC Billing Compliance Review Initiative. Primary source: California DHCS. Retrieved April 28, 2026, from https://www.fqhctalent.com/intel/dhcs-fqhc-billing-compliance-review-2026
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