MedicaidAdministrativeMedium impact
25-030 Provider Communications Posted Online and Operations Manual Updates for December 2024
Health Net·CA·Prior Authorization
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Health Net California released December 2024 policy updates covering multiple areas including expanded psychiatric emergency coverage, new TB screening requirements for ages 18+, changes to dual eligible Medi-Cal members starting January 1, 2025, and updated post-stabilization care authorization requirements. Key changes include injectable medication crosswalk updates and new AI utilization management requirements for delegated groups.
Action Required
By January 1, 2025: Billing teams should review the updated Injectable Medications HCPCS/DOFR Crosswalk for Q3 2024 coding changes. Update TB screening protocols for members 18+ per AB 2132 requirements. Verify post-stabilization care authorization processes align with single point of contact requirements per APL 24-012. Delegated PPGs must ensure AI utilization management policies meet new state requirements.