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CommercialPrior AuthHigh impact

25-056 State of Emergency: Southern California Windstorm and Fires

Health Net·CA·Prior Authorization
Effective date
Jan 7, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net is temporarily waiving prior authorization requirements and extending notification deadlines for providers in Los Angeles and Ventura counties affected by the January 7, 2025 state of emergency due to windstorms and fires. The policy also allows out-of-network services when contracted providers are unavailable and extends claim filing deadlines.

Action Required

Action needed
Immediately: Billing team should note that prior authorization is NOT required for Health Net members from fire-affected areas in LA/Ventura counties for acute care, post-acute care, DME, medical supplies, and home health services. Continue to submit notifications but deadlines are relaxed. Contact Health Net Provider Services at appropriate numbers for claim filing extensions and out-of-network service approvals. Document emergency circumstances in claims.