MedicaidAdministrativeMedium impact
25-1287 Provider Communications Posted Online and Operations Manual Updates for November 2025
Health Net·CA·Prior Authorization
Effective date
Nov 3, 2025
We identified it
Jun 20, 2026
Summary
HealthNet California published a comprehensive summary of November 2025 policy updates covering multiple areas including HEDIS medical record submission requirements starting January 2026, updated authorization guides for personal care services, and new confidentiality protections for immigration status in medical records.
Action Required
By January 2, 2026: Be prepared to submit medical records if randomly selected for HEDIS Measurement Year 2025 review. Review updated Personal Care and Homemaker Services authorization guides on CalAIM Resources page. Update medical record confidentiality procedures to protect immigration status and place of birth as protected health information per California SB 81.