MedicaidPrior AuthMedium impact
23-826 New Prior Authorization Requirements Effective October 15, 2023
Health Net·CA·Prior Authorization
Effective date
Oct 15, 2023
We identified it
Jun 20, 2026
Summary
HealthNet California is implementing new prior authorization requirements effective October 15, 2023 for medical benefit drugs and services in Fresno, Kings, and Madera counties. Providers must obtain prior authorization for newly listed medical services to avoid claim denials.
Action Required
By October 15, 2023: Download the Provider Update PDF from HealthNet's provider library to review the complete list of medical benefit drugs and services requiring new prior authorization. Update billing workflows and staff training to ensure prior authorization is obtained for all newly listed services before providing care to HealthNet Medi-Cal members in Fresno, Kings, and Madera counties. Failure to obtain required prior authorization will result in claim denials.