Medicare AdvantageAdministrativeMedium impact
23-1299 See What News Is Online for October 2023
Health Net·CA·Pharmacy
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
This is a summary bulletin of various policy updates posted in October 2023, including changes to Special Supplemental Benefits, medical record collection requirements, and updated medical policies. The most impactful change is the discontinuation of SSBCI benefits effective January 1, 2024, though affected members will automatically receive value-based insurance design programs.
Action Required
By December 31, 2023: Billing team should review the updated medical policies at bit.ly/HN_med_policies to understand new guidelines for medical necessity determinations. Be prepared for Datafied medical records collection requests between January 1 - May 3, 2024 for randomly selected patients. No immediate billing system changes required as this is primarily informational.