MedicaidPrior AuthMedium impact
23-986 State of Emergency: Impacts from Tropical Storm for Multiple Counties
Health Net·CA·Prior Authorization
Effective date
Aug 19, 2023
We identified it
Jun 20, 2026
Summary
CalViva Health (Medi-Cal) has temporarily relaxed prior authorization, referral, and claims filing requirements for providers in 15 California counties affected by Tropical Storm Hilary's state of emergency. The plan is also allowing out-of-network services and extending prescription refill limitations for impacted members.
Action Required
Immediately: Providers in affected California counties should contact CalViva Health Provider Services at 888-893-1569 for guidance on expedited prior authorizations, out-of-network service approvals, and extended claims filing deadlines. Billing team should be prepared to process out-of-network claims and extended filing periods for storm-impacted patients. Document storm impact for affected member encounters.