MedicaidAdministrativeMedium impact
25-1039 Provider Communications Posted Online and Operations Manual Updates for September 2025
Health Net·CA·Prior Authorization
Effective date
Sep 2, 2025
We identified it
Jun 20, 2026
Summary
Health Net California published September 2025 provider communications and operations manual updates covering multiple policy changes. Key changes include removing offshore subcontracting requirements, updating hospice care guidelines, modifying Community Health Worker service requirements, and various administrative updates to align with DHCS Medi-Cal contract amendments.
Action Required
By January 1, 2026: Ensure DHCS' Medi-Cal for Kids & Teens brochures are mailed or shared electronically to existing members annually. For new Medi-Cal members, send materials within seven calendar days of enrollment. Update workflow processes to use UD modifier and '08' in Basis of Cost Determination field for 340B Drug Pricing Program discounts. Review updated hospice care certification and documentation requirements per DHCS All Plan Letter 25-008.