CommercialPrior AuthHigh impact
24-801 Medical Medication PA Updates
Health Net·CA·Prior Authorization
Effective date
Jul 29, 2024
We identified it
Jun 20, 2026
Summary
HealthNet California has updated their prior authorization requirements for medical benefit drugs. Healthcare providers must now obtain prior authorization for specific medical medications listed in the policy update before administering or prescribing them to patients.
Action Required
Immediately: All providers must review the Provider Update PDF and identify which medical benefit drugs now require prior authorization. Update EMR systems and workflows to flag these medications for PA requirements before prescribing or administering. Train clinical staff on new PA requirements to avoid claim denials for covered medications.