Update – Calendar Year (CY) 2024 Medi-Cal Targeted Rate Increases (TRI) and Changes to PCP Capitation Rates
| Date: | December 12, 2024 |
| From: | Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) |
| To: | Health Plan Primary Care Providers and Capitation Payments |
| Type: | Regulatory |
| Subject: | Update – Calendar Year (CY) 2024 Medi-Cal Targeted Rate Increases (TRI) and Changes to PCP Capitation Rates |
| Business: | Medi-Cal Managed Care |
Health Plan recently communicated about the Medi-Cal Targeted Rate Increases (TRI) and changes to the new Primary Care Provider (PCP) capitation rates. Below is an update regarding capitation rates and payment:
- Health Plan is in the process of updating the PCP capitation rates to reflect TRI rates in January 2025.
- To be compliant for Calendar Year (CY) 2024, Health Plan will be issuing supplemental payments to providers, no later than December 31, 2024, to account for any capitation payments made during the calendar year that are less than the new calculated capitated 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
