MedicaidPrior AuthMedium impact
24-1001m Medical Policies - August 2024
Health Net·CA · Sleep Medicine, Pain Management, Orthopedics +2 more·Prior Authorization
We identified it
Jun 20, 2026
Summary
Centene/Health Net updated multiple medical policies for August 2024, including new sleep study guidelines, removal of neurosound/biosound coverage for biofeedback, approval of Spirit Diaphragm Pacing Transmitter, updated osteogenic stimulation criteria, shortened nerve block duration requirements from 6 to 4 weeks, and refined trigger point injection criteria. These changes affect prior authorization requirements and coverage criteria across multiple specialties.
Action Required
Immediately: Review updated prior authorization criteria for affected procedures. Billing team must verify current authorization requirements for sleep studies, biofeedback treatments, diaphragmatic nerve stimulation, osteogenic stimulation, selective nerve root blocks, and trigger point injections through the provider portal at 833-236-4141. Update internal protocols to reflect 4-week duration requirements for nerve blocks (reduced from 6 weeks) and discontinue authorization requests for neurosound/biosound biofeedback treatments as they are no longer covered.