MedicaidPrior AuthMedium impact
24-722, Continuity of Care for Medi-Cal Members
Health Net·CA · Physical Therapy, Occupational Therapy, Psychiatry·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net Medi-Cal now allows out-of-network providers to request continuity of care for members with pre-existing relationships (seen within 12 months prior to enrollment). Providers must accept Health Net contract rates, meet professional standards, and provide medical records to validate the relationship.
Action Required
Immediately: Billing team should identify Medi-Cal members who may qualify for continuity of care with out-of-network providers. Front desk staff must verify pre-existing relationships within 12 months prior to Health Net enrollment and gather medical records for validation. Contact Member Services on member ID card to request continuity of care authorization. Ensure acceptance of Health Net contract rates or Medi-Cal fee-for-service rates before providing services.