CommercialAdministrativeMedium impact
25-1136m Submit Medical Records for HEDIS Review Starting January 2, 2026
Health Net·CA·Prior Authorization
Effective date
Jan 2, 2026
We identified it
Jun 20, 2026
Summary
Health Net will begin collecting medical records from randomly selected physicians and physician groups starting January 2, 2026, for HEDIS quality measurement review. Providers must submit requested records within 7 business days using the contracted vendor Datafied at no cost, or use their own vendor at their expense.
Action Required
Before January 2, 2026: Administrative staff must establish workflow for responding to Health Net HEDIS record requests within 7 business days. Ensure contact information is current with Health Net. When contacted by Datafied, immediately prepare requested medical records or complete Certificate of No Record (CNR) forms. Contact Datafied at 714-666-0951 if additional time is needed. Failure to respond timely may result in follow-up compliance actions.