MedicaidPrior AuthMedium impact
26-356m Updates to Clinical Policies – February 2026
Health Net·CA · Transplant Surgery, OB-GYN, Oncology +11 more·Prior Authorization
Effective date
Feb 1, 2026
We identified it
Jun 20, 2026
Summary
Community Health Plan of Imperial Valley updated multiple clinical policies effective February 2026, including changes to prior authorization requirements for various transplant procedures, home birth criteria, assisted reproductive technologies, and extensive updates to genetic testing policies across multiple specialties.
Action Required
Before February 1, 2026: Review and update prior authorization workflows for affected procedures including pancreas transplants, allogeneic hematopoietic cell therapy, tandem transplants, home births, and hypoglossal nerve stimulation. Update genetic testing prior authorization requirements across all specialties. Contact Community Health Plan at 833-236-4141 for specific questions about new requirements.