MedicaidPrior AuthMedium impact
26-159 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
Health Net California updated their Provider Operations Manual for January 2026 with multiple changes including new prior authorization timelines for enteral nutrition (reduced to 7 calendar days), updated HIV test result disclosure requirements, new reimbursement timelines and penalties for late claims, and addition of Transitional Rent benefits.
Action Required
By January 1, 2026: Billing teams must update prior authorization processes for enteral nutrition to comply with new 7-calendar day timeline for both Medi-Cal and Medicare. Update staff training on new reimbursement timelines and late claim penalties per AB 3275. Review updated prior authorization forms available in Provider Library Forms and References section. Ensure compliance with new HIV test result disclosure requirements per SB 0278.