MedicaidPrior AuthMedium impact
26-037 Updated Personal Care and Homemaker Authorization Form: Requests Are Limited to 10 Hours Daily
Health Net·CA · Family Medicine, Internal Medicine, General Practice +1 more·Prior Authorization
Effective date
Mar 25, 2026
We identified it
Jun 20, 2026
Summary
Effective March 25, 2026, Personal Care and Homemaker Services authorization requests are now limited to a maximum of 10 hours per day combined for In-Home Supportive Services and Personal Care and Homemaker Services. Any requests exceeding this daily limit will be automatically denied, and members requiring more care should be referred to Enhanced Care Management or their primary care provider.
Action Required
Before March 25, 2026: Billing team must update authorization request processes to ensure Personal Care and Homemaker Services requests do not exceed 10 hours per day when combined with In-Home Supportive Services. Update the Personal Care and Homemaker Services Authorization Form from CalAIM provider resources. Train staff to refer members needing more than 10 hours daily to Enhanced Care Management or primary care providers. Requests exceeding the limit will be denied.