Medicare AdvantageAdministrativeMedium impact
25-422 Provider Communications Posted Online and Operations Manual Updates for April 2025
Health Net·CA·Prior Authorization
Effective date
Apr 1, 2025
We identified it
Jun 20, 2026
Summary
This is a summary document listing all provider communications and operations manual updates made in April 2025, including updates to prior authorization processes, formulary changes, and new resources for various plan types. Key changes include clarified prior authorization contact information and processes, medication formulary updates for Q2 2025, and enhanced care management information.
Action Required
Review the updated Prior Authorization Process documents effective April 11, 2025 to verify current contact information for submitting prior authorization requests via phone, fax or online. Check the Medication Trend Updates and Formulary Changes document (25-383m) for any medications that may affect patient treatments and billing. Review updated Care Management Referral Form that now includes palliative care referral contacts.