What types of policy changes does Health Net issue?

Health Net regularly publishes coverage updates including prior authorization requirement changes, billing code additions or deletions, plan-type coverage modifications, and clinical policy revisions. PolicyChanges.app monitors these notices and summarizes the impact for providers.

How often does Health Net update its policies?

Health Net typically releases policy bulletins on a rolling basis throughout the year. Our system checks for new updates daily and adds them to this feed as soon as they are identified.

How many Health Net policy changes are tracked here?

This page currently tracks 50 documented Health Net policy changes. New items are added as they are identified.

What should I do when Health Net changes a prior authorization policy?

Review each change's effective date and action-required notes. Update your billing and clinical workflows before the effective date to avoid claim denials. Each policy detail page on PolicyChanges.app includes a plain-English summary and action items.

Health Net Policy Changes 2026 | Prior Auth & Coverage Updates

Health Net Policy Changes & Prior Auth Updates

We track 50 documented policy changes from Health Net across CA. Each entry includes an AI-generated plain-English summary, effective date, affected billing codes, and a direct link to the original Health Net notice. Use the related links below to narrow results by specialty or state, or sign up for a free daily alert to receive new Health Net updates automatically.

Medium impact

26-282m New State-Mandated Chaperone Requirements for Sensitive Ultrasound Exams Start January 1, 2027

Health Net·Effective Jan 1, 2027

Starting January 1, 2027, California providers performing sensitive ultrasound examinations (genitalia, breast, rectum, pubic/groin areas) must notify patients that trained medical chaperones are available, provide chaperones upon request, and document chaperone use in medical records. All staff serving as chaperones must receive specific training on observation techniques, patient draping, neutrality, and reporting procedures.

26-580 New Claims Editing Requirements for Established Patient Billing and Bundled Codes

26-750 CalAIM PHM Update: New Requirements for Pregnancy Care, IHAs and Care Coordination

26-749 CalAIM PHM Update: New Requirements for Pregnancy Care, IHAs and Care Coordination

26-642 Submit Medi‑Cal Rx and Fee‑for‑Service Carved‑Out Medication Claims Correctly

26-643 Submit Medi‑Cal Rx and Fee‑for‑Service Carved‑Out Medication Claims Correctly

26-641 Submit Medi‑Cal Rx and Fee‑for‑Service Carved‑Out Medication Claims Correctly

26-773 IONM Billing Requirements Change, Effective August 14, 2026

26-690 Monthly Membership Report Detail Data File Layout Change, Effective July 2026

26-733 Medi-Cal Subnetwork Certification: Get Ready for the July Assessment

26-734 Medi-Cal Subnetwork Certification: Get Ready for the July Assessment

26-735 Medi-Cal Subnetwork Certification: Get Ready for the July Assessment

26-748 CalAIM PHM Update: New Requirements for Pregnancy Care, IHAs and Care Coordination

26-592 Medi‑Cal Hospice Prior Authorization Update for Hospice Providers

26-593 Medi‑Cal Hospice Prior Authorization Update for Hospice Providers

26-594 Medi‑Cal Hospice Prior Authorization Update for Hospice Providers

26-660 Changes to Authorization Periods for Select Community Supports Services

26-661 Changes to Authorization Periods for Select Community Supports Services

26-662 A Change in Authorization Periods for Select Community Supports Services

26-715 New Online Provider Onboarding Training Attestation for Medi-Cal

26-716 New Online Provider Onboarding Training Attestation for Medi-Cal

26-717 New Online Provider Onboarding Training Attestation for Medi-Cal

26-282m New State-Mandated Chaperone Requirements for Sensitive Ultrasound Exams Start January 1, 2027

26-281m New State-Mandated Chaperone Requirements for Sensitive Ultrasound Exams Start January 1, 2027

26-283m New State-Mandated Chaperone Requirements for Sensitive Ultrasound Exams Start January 1, 2027

26-373 New California Credentialing Requirements Under AB 1041: Phased Implementation (2026-2028)

26-333sum Summary Update: 1st Quarter 2026 Injectable Medication HCPCS/DOFR Crosswalk

26-334sum Summary Update: 1st Quarter 2026 Injectable Medication HCPCS/DOFR Crosswalk

26-742 Provider Communications Posted Online and Operations Manual Updates for May 2026

26-741 Provider Communications Posted Online and Operations Manual Updates for May 2026

26-253 Evolent Removes Prior Authorization for Select Radiology and Cardiology Services

26-086 Act Now to Avoid Claim Payment Delays: Choose Your Electronic Payment Option

26-088 Act Now to Avoid Claim Payment Delays: Choose Your Electronic Payment Option

26-073 Updates to the Prior Authorization Requirements

26-074 Updates to the Prior Authorization Requirements

26-075 Updates to the Prior Authorization Requirements

26-084 Commercial Plans Will No Longer Accept Medicare-Specific G-Codes Starting April 1, 2026

26-085 Important Update to Medicare Add-On Codes G2211 and G2212

26-585 Updated Youth Trauma Screening Requirements

26-584 Updated Youth Trauma Screening Requirements

26-586 Updated Youth Trauma Screening Requirements

26-629 Updates to Prior Authorization Requirements

26-630 Updates to Prior Authorization Requirements

25-1239 Action Required: CPT Code 80050 Coverage Ends January 31, 2026

26-355m Updates to Clinical Policies – February 2026

26-357m Updates to Clinical Policies – February 2026

25-1114 Hospice Documentation Deadlines Enforced Starting January 8, 2026

25-1115 Hospice Documentation Deadlines Enforced Starting January 8, 2026

25-1116 Hospice Documentation Deadlines Enforced Starting January 8, 2026

25-727 Claims Will Be Paid Faster Thanks to New California Law

25-729 Claims Will Be Paid Faster Thanks to New California Law