CommercialCoverageMedium impact
25-024m Medication Trend Updates and Formulary Changes - 1st Quarter 2025
Health Net·CA·Pharmacy
We identified it
Jun 20, 2026
Summary
HealthNet California has released quarterly formulary changes affecting medication coverage and drug benefit changes for Q1 2025. Medical billing teams need to review the updated drug list and formulary to ensure proper billing for pharmacy-related services and medication administration.
Action Required
Immediately: Download and review the Provider Update PDF from HealthNet's provider library to identify specific formulary changes. Update billing procedures for any affected medication administration codes and verify coverage for drugs commonly prescribed in your practice. Notify providers of any formulary restrictions that may impact prescribing decisions.