Short-Term Post Hospital Housing Benefit Concluding December 31, 2026
| Date: | August 12, 2026 |
| From: | Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) |
| To: | Health Plan Practitioners, Facilities, Community Based Organizations (Enhanced Care Management and Community Supports Providers), and Hospitals |
| Type: | Informational/Educational |
| Subject: | Short-Term Post Hospital Housing Benefit Concluding December 31, 2026 |
| Business: | Medi-Cal Managed Care |
Short-Term Post Hospital Housing (SPTHH) will no longer be a covered Medi-Cal benefit beginning January 1, 2027. Health Plan would like to share the following information with you to ensure understanding of this change:
- Health Plan will limit any new authorizations received on or after July 1, 2026, and authorizations cannot extend after December 31, 2026, as this is the end of the state’s coverage authority for this service.
- Following Medi-Cal rules, when we authorize a shorter duration of STPHH than requested, this constitutes an adverse benefit determination, and applicable appeal rights will be available.
- Effective December 1, 2026, no new authorizations will be issued. Members seeking STPHH should be considered for recuperative care (medical respite) or other available community supports.
- Members will be notified of any requests received on or after July 1, 2027, a Notice of Action (NOA) will be sent to the member that the maximum duration cannot be authorized.
- All authorizations that have been issued by Health Plan that exceed December 31, 2026, will be shortened to comply with the statewide end date and a NOA will be sent notifying the member of this change.
- A notification to all members regarding this change in coverage will be sent no later than December 1, 2026
- Members who have authorizations approaching December 31, 2026 will receive appropriate transition planning, which may include:
• Linkage to Recuperative Care, Transitional Rent, other Community
Supports and ECM, based on the Member’s needs.
• Other Covered Medi-Cal benefits, such as the Community Health
Worker (CHW) Benefit, to the extent Members may be appropriately
supported by CHW services and there is not duplication of payments.
If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan and our services is always available on our website www.hpsj-mvhp.org
