MedicaidPrior AuthMedium impact
23-1261 Transportation Benefit for Members in Long-Term Care
Health Net·CA·Prior Authorization
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
Health Net now requires providers to complete a Physician Certification Statement (PCS) form for long-term care members in skilled nursing facilities to receive non-emergency medical transportation services. Without this form, members will not receive necessary transportation to medical appointments.
Action Required
Immediately: Providers must complete and submit PCS forms to Health Net's transportation vendor (Modivcare) or delegated entity when LTC members in skilled nursing facilities need non-emergency medical transportation. Download the PCS form from Health Net's provider library. For recurring appointments, authorization covers up to 12 months. Without completed PCS forms, members will not receive transportation services.