October 7, 2026
Access California/Providers for the latest operational and plan updates to better service your patients.
The table below outlines operations manual changes made in September 2026.
| Effective Date | Section | Topic | Summary |
|---|---|---|---|
| 9/2/26 | All | All | Added a formal Corrective Action Plan policy and procedure to standardize how performance issues are addressed and resolved for IPAs under Section 9: Quality Improvement. Additionally, multiple edits made throughout manual to ensure content is current. |
| 9/22/26 |
A:8: Utilization Management B:14: Attachments |
a. Utilization Management Program b. Member Rights and Responsibilities |
Updated section to clarify that IPAs delegated for utilization management (UM) are responsible for ensuring that clinical reviews, recommendations and determinations are performed only by appropriately licensed professionals acting within their scope of practice, as required by California law and state regulations. Licensed vocational nurses may support UM activities within their scope of practice but may not make clinical recommendations or UM determinations. |
Access communications and the operations manual
- Go to www.wellcare.com/California/Providers.
- Communications: Select Provider Bulletins.
- Operations manual: From the Provider menu at the top of page, select Overview under the Medicare column > Download the provider manual PDF document.
If you have questions regarding the information contained in this update, contact 866-999-3945.
