Medicare AdvantageAdministrativeMedium impact
24-1253 Provider Communications Posted Online and Operations Manual Updates for November 2024
Health Net·CA·Prior Authorization
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Health Net California published their November 2024 provider communications summary, including updates to medical policies, drug formulary changes, and operational manual revisions. Key changes include D-SNP authorization requirements for PPGs to check both Medicare and Medi-Cal benefits, bariatric center updates, and vision vendor changes from Centene Vision to Premier Eye Care.
Action Required
By January 1, 2025: For D-SNP members, billing team must verify both Medicare and Medi-Cal benefits before submitting prior authorization requests. Update bariatric surgery provider lists with new Centers of Excellence. Replace Centene Vision contact information with Premier Eye Care for Medicare vision services. Review updated medical policies for October and November 2024 at Health Net's provider portal.