Provider Alerts

In accordance with the Department of Health Care Service (DHCS) publication, effective July 2024, the Child Health and Disability Prevention (CHDP) Gateway has been rebranded to the Children’s Presumptive Eligibility (CPE) Portal. Provider participation in Presumptive Eligibility (PE) has also been expanded. Effective for dates of service on or after July 1, 2024, most Medi-Cal and Medi-Cal Dental fee-for-service provider types can enroll children into temporary coverage through PE. For more information, please visit: https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32590.07

Children’s Presumptive Eligibility (CPE) 

As listed below, CPE eligibility requirements are the same as those under the CHDP Gateway, except for periodicity. Periodicity will no longer be a basis for denying eligibility. Additionally, providers will not complete a Medically Necessary Inter-periodic Health Assessment (MNIHA). Determinations continue to be based on the applicant/family’s self-attestation of facts on the application.

Applicants are potentially eligible for CPE if they are:

• Under the age of 19
• A California resident
• Not receiving Medi-Cal
• Within the income limits for their household size
• Have not exceeded two PE enrollment periods in the last 12 months

For more information about CPE, email at ChildrenPE@dhcs.ca.gov or visit:  https://mcweb.apps.prd.cammis.medi-cal.ca.gov/references/cpe

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