MedicaidPrior AuthMedium impact
25-1226 Prior Authorization Updates Now in Effect - More Changes Coming in Early 2026
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
HealthNet California has implemented new prior authorization updates affecting medications, with reclassifications and CMS code changes now in effect. The policy specifically applies to Medi-Cal providers in Fresno, Kings, and Madera counties, with additional changes planned for early 2026.
Action Required
Immediately: Download and review the Provider Update PDF from HealthNet California's provider library. Billing teams must identify specific medication additions, removals, and reclassifications that affect their practice. Update prior authorization workflows and billing system rules based on the new CMS code changes. Monitor for additional updates coming in early 2026.