MedicaidPrior AuthMedium impact
26-594 Medi‑Cal Hospice Prior Authorization Update for Hospice Providers
Health Net·CA · Palliative Care·Prior Authorization
Effective date
Jul 9, 2026
We identified it
Jun 20, 2026
Summary
Starting July 9, 2026, Health Net Medi-Cal managed care will require prior authorization for outpatient hospice services (routine home care, continuous home care, and respite care outside inpatient settings) in Imperial County. Hospice providers must submit prior authorization requests with required documentation to support medical necessity.
Action Required
Before July 9, 2026: Hospice providers must update workflows to submit prior authorization requests for all outpatient hospice services (routine home care, continuous home care, and respite care) with Health Net Medi-Cal. Ensure all required documentation is included: Certificate of Terminal Illness, signed Election Notice, individualized care plan, and applicable transfer/discharge summaries. Contact Community Health Plan of Imperial Valley at 833-236-4141 for questions. Failure to obtain prior authorization may result in claim denials.