MedicaidPrior AuthMedium impact
24-723, Continuity of Care for Medi-Cal Members
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
CalViva Health updated continuity of care procedures for Medi-Cal members, allowing out-of-network providers with pre-existing relationships to request continuity of care authorization. Providers must accept Medi-Cal rates and meet quality standards to participate.
Action Required
Immediately: For Medi-Cal patients in Fresno, Kings, and Madera counties, billing team and providers should identify members with pre-existing relationships from the past 12 months. Contact Member Services number on patient ID card to request continuity of care authorization. Prepare to provide medical records to validate pre-existing relationships. Accept Medi-Cal fee-for-service rates for continuity care patients.