Important Notice for HPN’s Medicaid Providers - Updated 10/23/2025
Below is a summary of updates for Health Plan of Nevada Medicaid. Additional details will be provided as they become available. Information provided in this notification is subject to change.
Health Plan of Nevada Medicaid Service Area Reduction
Effective January 1, 2026, HPN’s Medicaid service area will be Urban Clark County only. We are working with Nevada Medicaid to help implement the successful transition of our Washoe County and Rural Clark County members to another MCO.
Plan Name Update
We updated our Medicaid plan name to Health Plan of Nevada Medicaid to more closely align with our local HPN products and services. There are no changes to how our providers work with us.
Changes Coming to Medicaid Plans Impacting Approximately 45,000 HPN Medicaid Members
Nevada Medicaid Implementing Redistribution of Medicaid Membership
Nevada Medicaid will implement the redistribution of Medicaid enrollees who reside in Urban Clark County, Rural Clark County and Washoe County for the mandatory managed care delivery program effective January 1, 2026.
- Beginning January 1, 2026, Nevada’s Medicaid program will have five MCOs: Health Plan of Nevada, Anthem, SilverSummit, Molina and CareSource. Nevada Medicaid will redistribute a percentage of membership to CareSource for an effective date of January 1, 2026.
- In October, Nevada Medicaid will mail impacted members a pre-distribution letter notifying them that they will be moved to CareSource effective January 1, 2026.
- Redistributed members in Urban Clark County will have the opportunity to switch back or change to HPN during the 90-day choice period from January 1 to March 31. Please click here for member benefits to switch back to HPN.
- There are some parameters set by Nevada Medicaid regarding which members are eligible for redistribution based on active treatment or health condition, such as pregnancy. HPN will work with our providers to identify these members.
- Click here for more information.
Nevada Medicaid’s Open Enrollment Period Has Changed
This year’s open enrollment period for Medicaid members in Nevada is October 1 through December 26.
- Open enrollment letters will be mailed by Nevada Medicaid to non-redistributed members in October.
- Members in Urban Clark County who switch to a different plan during open enrollment can switch to HPN during the 90-day choice period from January 1 to March 31. Please click here for member benefits to switching to HPN.
Health Plan of Nevada Medicaid provides members with several programs and services to help support whole-person care
Disease Management Programs
Giving members the tools they need with support from a registered nurse. Programs include asthma management, diabetes management and kidney disease management.
Health Education and Wellness
Health coaches educate on topics to help members lead a healthier life. Online programs include diabetes, healthy lifestyle changes and healthy pregnancy. Wellness support includes prediabetes, diabetes, nutrition, breastfeeding support, tobacco/nicotine cessation, healthy kids and weight management.
Community Health Workers
Our community health workers assist with coordinating community resources so members can access food, jobs, clothing, transportation, housing and rental assistance.
Case Management Services
HPN’s case managers support members with case management services, including pediatric, obstetric, adult and behavioral health.
Language Line Support
Health Plan of Nevada Medicaid provides access to our contracted language line vendor for your interpretation needs. To access this free service, please call Member Services at 1-800-962-8074, TTY 711.
Transportation
Qualified members can receive free bus passes and free rides to medical and behavioral health appointments, pharmacies and social services.
Value-Added Benefits
We also provide several value-added benefits to members at no cost, including specialty items for families, extra support and housing assistance. For a full list of no-cost extra benefits, click here.
Want to learn more?
For more information on how we support your Health Plan of Nevada Medicaid patients, contact your provider advocate.
This page has been updated as of October 23, 2025. HPN will continue to update our Medicaid providers as new information becomes available. If you have specific questions about this notice, please contact your provider advocate.