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CommercialPrior AuthMedium impact

24-033m Follow the Prior Authorization Requirements to Submit Palliative Care Requests

Health Net·CA · Palliative Care, Oncology, Family Medicine +1 more·Prior Authorization
Effective date
Jan 26, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

HealthNet California now requires prior authorization for palliative care services. Providers must confirm diagnosis for advanced acute illness before submitting palliative care requests through the standard prior authorization process.

Action Required

Action needed
Immediately: Billing team must update workflow to obtain prior authorization before scheduling or billing palliative care services. Providers must confirm and document advanced acute illness diagnosis. Front desk staff should verify prior auth status before appointments. Claims without prior authorization will be denied.