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MedicaidAdministrativeMedium impact

24-871 Provider Communications Posted Online and Operations Manual Updates for July 2024

Health Net·CA·Prior Authorization
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net California published their July 2024 provider communications summary and operations manual updates, including multiple changes to Medi-Cal policies. Key updates include new privacy protections for sensitive medical information, drug utilization review requirements, pharmacist billing provisions, and continuity of care requirements.

Action Required

Action needed
Billing team should review the Provider Library for all July 2024 operations manual updates, particularly: 1) Implement enhanced privacy protections for sensitive medical information per AB 352 and SB 345, 2) Update drug utilization review procedures per APL 23-026, 3) Review new pharmacist billing provisions under AB 317, 4) Update continuity of care processes per APL 23-022, and 5) Note that Envolve Vision is now Centene Vision Services for vision claims.