MedicaidPrior AuthMedium impact
24-131 Use Our Preferred Vendors for DME and Incontinence Medical Supplies
Health Net·CA · Family Medicine, Internal Medicine, General Practice +4 more·Prior Authorization
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Health Net Medi-Cal now requires providers to refer members to specific preferred vendors for durable medical equipment (DME) and incontinence supplies, with prior authorization required for DME. This affects members who transitioned from California Health & Wellness Plan to Health Net in specific counties.
Action Required
Immediately: Billing team and providers must update referral processes to use only Health Net preferred vendors for DME and incontinence supplies. Update referral forms and EMR templates with the provided vendor contact list (Apria Healthcare, Lincare, SuperCare, etc.). Ensure prior authorization is obtained for all DME orders before referring to preferred vendors. Train staff on new vendor requirements to prevent claim denials.