MedicaidPrior AuthMedium impact
24-1002m Medical Policies - August 2024
Health Net·CA · Sleep Medicine, Pain Management, Neurology +2 more·Prior Authorization
Effective date
Aug 1, 2024
We identified it
Jun 20, 2026
Summary
CalViva Health updated multiple medical policies for August 2024, including new sleep study guidelines for adults and pediatrics, and revised criteria for pain management procedures like nerve blocks (reduced duration from 6 to 4 weeks) and trigger point injections. The policy also removes coverage for neurosound/biosound biofeedback treatments due to insufficient scientific evidence.
Action Required
Immediately: Billing team must review and update prior authorization requirements for sleep studies, nerve blocks, trigger point injections, diaphragmatic nerve stimulation, and osteogenic stimulation procedures. Stop billing for neurosound/biosound biofeedback treatments as they are no longer covered. Update documentation requirements for nerve blocks to reflect new 4-week duration criteria instead of 6 weeks. Access CalViva provider portal at 888-893-1569 for specific prior authorization requirements for each updated policy.