Medicare AdvantagePrior AuthMedium impact
24-1255 Provider Communications Posted Online and Operations Manual Updates for November 2024
Health Net·CA·Prior Authorization
Effective date
Nov 25, 2024
We identified it
Jun 20, 2026
Summary
HealthNet California released November 2024 updates including key changes for D-SNP members requiring PPGs to check both Medicare and Medi-Cal benefits before denying prior authorizations, updated interpreter service contact information, and notification of annual medical records collection starting January 2, 2025.
Action Required
Immediately: Update prior authorization workflow for D-SNP (Dual Special Needs Plan) members - billing team must verify both Medicare AND Medi-Cal coverage before denying any prior authorization requests as 'not covered benefit'. Update interpreter services contact information to new numbers provided. By January 2, 2025: Prepare for annual medical records collection for HEDIS compliance review.