MedicaidAdministrativeMedium impact
24-159 Provider Communications Posted Online and Operations Manual Updates for January 2024
Health Net·CA · Palliative Care, Sleep Medicine, Dentistry·Prior Authorization
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
This policy provides a comprehensive summary of multiple Medi-Cal operational updates implemented in January 2024, including changes to prior authorization requirements for palliative care and sleep studies, expanded telehealth access, new dental sedation coverage, and various administrative updates to provider operations manuals.
Action Required
Immediately: Review and implement multiple operational changes including: 1) Use updated Outpatient Medi-Cal Prior Authorization Form for palliative care requests with mandatory information fields, 2) Follow new prior authorization process for sleep studies effective January 5, 2024, 3) Update billing procedures for intravenous moderate sedation and deep sedation/general anesthesia services provided by physicians in conjunction with dental services, 4) Update behavioral health claims submission address and payer ID information. Contact CalViva Health at 888-893-1569 for questions.