CommercialPrior AuthHigh impact
24-542 Prior Authorization Extensions for All Services, Including DME, Ends June 30, 2024
Health Net·CA·Prior Authorization
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Summary
Health Net is reverting prior authorization approval timeframes from 6 months back to 3 months for all services including durable medical equipment (DME), ending the COVID-19 pandemic extension. This affects all prior authorization requests approved on or after July 1, 2024.
Action Required
By July 1, 2024: Update prior authorization tracking systems to reflect new 3-month approval timeframes instead of 6 months for Health Net plans. Train staff to monitor authorization expiration dates more frequently and establish alerts at 2.5 months to allow time for reauthorization requests. Update patient scheduling protocols to avoid booking services beyond the 3-month authorization window.