MedicaidPrior AuthMedium impact
26-405 Updates to Prior Authorization Requirements
Health Net·CA·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
HealthNet California has updated prior authorization requirements for Medi-Cal members in Fresno, Kings, and Madera counties, effective January 1 through June 1, 2026. The policy references changes to specific prior authorization codes, though the detailed code list requires downloading the PDF document.
Action Required
By January 1, 2026: Billing team must download the Provider Update PDF from HealthNet California's provider library to review specific prior authorization code changes. Update billing system and prior authorization workflows for Medi-Cal patients in Fresno, Kings, and Madera counties according to the new requirements. Failure to obtain required prior authorizations may result in claim denials.