MedicaidPrior AuthMedium impact
25-946 Provider Communications Posted Online and Operations Manual Updates for August 2025
Health Net·CA·Prior Authorization
Effective date
Aug 19, 2025
We identified it
Jun 20, 2026
Summary
HealthNet California released updated provider communications and operations manual changes for August 2025, including a new enhanced prescription drug prior authorization form with updated contact information and clarifications on emergency claims billing following CMS guidelines when DHCS is silent.
Action Required
Immediately: Replace old prescription drug prior authorization forms with the new enhanced version (effective 8/19/25 and updated 8/26/25). Update pharmacy services fax contact information in billing system. Train staff on new form requirements for prescription drug prior authorizations and step-therapy exceptions to avoid returned requests.