MedicaidAdministrativeMedium impact
24-957m Improve Members' Experience with Care Coordination
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net California has issued new care coordination guidelines emphasizing improved communication between providers, timely follow-up after hospitalizations, and comprehensive information sharing. The policy particularly focuses on behavioral health coordination requirements for members with psychotropic medications, substance abuse disorders, or major mental illness.
Action Required
Immediately: Providers should implement enhanced care coordination workflows including: 1) Obtain patient consent for medical record requests from other providers at each visit, 2) Follow up with hospitalized patients within one week of discharge, 3) Share assessment results and diagnoses with other treating providers within one week after obtaining consent, 4) For behavioral health patients on psychotropic medications or with substance abuse/major mental illness, ensure appropriate authorization forms are signed and filed for future information sharing needs.