MedicaidPrior AuthMedium impact
24-574 Provider Communications Posted Online and Operations Manual Updates for May 2024
Health Net·CA·Prior Authorization
Effective date
May 6, 2024
We identified it
Jun 20, 2026
Summary
Health Net California published a summary of provider communications and operations manual updates from May 2024, including new prior authorization exemptions for American Indian members and updates to medical policies. The most significant change exempts certain services for American Indian members from prior authorization requirements.
Action Required
Review updated Services Not Requiring Prior Authorization document in the Provider Operations Manual to identify which services for American Indian members no longer require prior authorization. Update billing workflows and staff training to ensure proper handling of claims for American Indian members. Verify patient eligibility and tribal affiliation when processing claims to apply correct authorization requirements.