California Healthcare Consulting
California behavioral health & SUD consulting.
California-specific consulting for behavioral health, substance use, and medical groups — DHCS licensure, Department of Health Care Services certifications, Medi-Cal MCO contracting, and commercial behavioral carve-outs.
Payers & networks
Where California contracting actually happens.
Medi-Cal Managed Care
Contracting with the Medi-Cal MCOs operating in each county including Anthem Blue Cross, Health Net, Molina, Kaiser, and county-organized health systems.
Commercial Behavioral
Optum, Carelon (Anthem BCBS), Aetna BH, Cigna/Evernorth, Magellan, and Beacon for California behavioral and SUD networks.
DHCS & DMHC
DHCS SUD licensure & Drug Medi-Cal certification; DMHC plan oversight for behavioral health parity.
VA CCN Region 4
VA Community Care Network Region 4 (Optum) contracting for California veterans.
Tricare West
Tricare West Region (TriWest) network contracting for active-duty and dependent populations.
County Carve-Outs
County Mental Health Plans (MHPs) and Drug Medi-Cal Organized Delivery System (DMC-ODS) contracts.
What we deliver in California
End-to-end California consulting.
Licensure, accreditation, payer contracting, and revenue cycle — sequenced for the realities of operating in California.
- DHCS SUD licensure
- Drug Medi-Cal certification
- County MHP contracting
- DMC-ODS contracting
- Commercial carve-out contracting
- CARF & Joint Commission
- Medi-Cal MCO enrollment
- Provider credentialing
- Revenue cycle setup
- Compliance & audit prep
FAQ
California contracting, answered.
- What's required to open an SUD program in California?
- DHCS licensure for residential and outpatient SUD, Drug Medi-Cal certification if you intend to bill Medi-Cal, and accreditation (CARF or Joint Commission) for commercial contracting. Each county also operates under DMC-ODS or fee-for-service Medi-Cal — your county determines the contracting pathway.
- Do I need to contract with each Medi-Cal MCO separately?
- Yes. Each Medi-Cal Managed Care Plan credentials and contracts providers independently, and county-specific plans (Partnership, CalOptima, IEHP, etc.) operate alongside statewide plans. We map your county footprint and sequence applications by plan.
- How does the DMC-ODS waiver affect contracting?
- Counties operating under DMC-ODS contract directly with SUD providers under a managed care–style structure. Counties not on DMC-ODS use traditional Drug Medi-Cal fee-for-service. Your county and level of care determine which pathway applies.
- Are commercial behavioral networks open in California?
- Mostly closed for residential SUD in saturated markets (Orange County, LA). Open or selectively open for mental health, IOP, and outpatient. Network-need justification and clinical differentiation are required for closed-panel applications.
Operating in California
Build a defensible California payer mix.
From DHCS licensure to Medi-Cal MCOs and commercial carve-outs — sequenced for California's regulatory and county-by-county complexity.