CommercialCoverageHigh impact
26-001m Site of Care Optimization for Therapeutic Infusions (SCOTI) - 1st Quarter 2026
Health Net·CA · Rheumatology, Oncology, Hematology +6 more·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Health Net is launching a Site of Care Optimization for Therapeutic Infusions (SCOTI) program partnering with Coram CVS Specialty to offer eligible Commercial and Exchange members home infusion and alternative sites for therapeutic infusions. The program covers a wide range of medications for conditions including autoimmune disorders, immune deficiencies, multiple sclerosis, and rare disorders.
Action Required
By January 1, 2026: Billing team must identify patients receiving therapeutic infusions for eligible conditions and determine financial responsibility using the Health Net Injectable Medication HCPCS/DOFR Crosswalk. For Health Net financially responsible cases, coordinate with Coram CVS Specialty (866-899-1661) and reference the SCOTI program. Update patient referral workflows to include home infusion options for eligible medications.