MedicaidPrior AuthHigh impact
26-160 Provider Communications Posted Online and Operations Manual Updates for January 2026
Health Net·CA·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
HealthNet California has released comprehensive policy updates for January 2026 affecting Medi-Cal providers in Fresno, Kings, and Madera counties. Key changes include updated prior authorization timelines (reduced to 7 calendar days for enteral nutrition), new HIV test result disclosure requirements, updated claims reimbursement penalties, and new Transitional Rent benefit coverage.
Action Required
By January 1, 2026: Billing teams must update prior authorization processes to ensure enteral nutrition requests are processed within 7 calendar days for Medi-Cal and Medicare patients. Update HIV test result disclosure procedures per Senate Bill 0278. Review and implement new claims reimbursement timelines per Assembly Bill 3275. Download updated prior authorization forms from the Provider Library Forms and References section. Failure to comply may result in claim denials and reimbursement penalties.