CommercialPrior AuthMedium impact
25-815 Provider Communications Posted Online and Operations Manual Updates for July 2025
Health Net·CA · Psychiatry, OB-GYN, Palliative Care·Prior Authorization
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Summary
Health Net California published multiple policy updates for July 2025, including medication formulary changes, new prior authorization requirements through the Availity Essentials portal for behavioral health services, and updates to provider directory maintenance requirements. Key changes include expanded infertility treatment coverage and new requirements for hospitals to maintain adequate staffing.
Action Required
Immediately: Update behavioral health prior authorization workflow to use Availity Essentials portal as of July 1, 2025. Review formulary changes for Q3 2025 and update preferred drug lists. Ensure provider demographic information is current to avoid directory removal. Review expanded infertility treatment coverage requirements for large group plans effective July 1, 2025.