MedicaidAdministrativeMedium impact
24-724, 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 now allows out-of-network providers to request continuity of care for Medi-Cal members who had a pre-existing relationship (seen within 12 months prior to enrollment). Providers must accept Medi-Cal rates, meet quality standards, and provide medical records to validate the relationship.
Action Required
Immediately: For Medi-Cal members requesting continuity of care with out-of-network providers, contact Member Services using the number on the member ID card to initiate the request. Gather medical records from the past 12 months to validate pre-existing relationships. Ensure providers understand they must accept Medi-Cal fee-for-service rates and cannot refer to other out-of-network providers without plan authorization.