Medicare AdvantagePrior AuthHigh impact
23-824 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
Health Net California is implementing new prior authorization requirements effective October 15, 2023, for medical benefit drugs and services across multiple lines of business including Medicare Advantage, Commercial, and Medi-Cal plans. The policy affects all provider types including physicians, hospitals, clinics, and ancillary providers throughout California.
Action Required
By October 15, 2023: Billing team must download the Provider Update PDF from Health Net to identify specific drugs and services requiring prior authorization. Update billing system workflows to flag and obtain prior authorization for all listed medical benefit drugs and services before rendering care. Train front desk staff to verify prior auth requirements during scheduling. Contact Health Net Provider Services at 800-675-6110 or provider_services@healthnet.com for specific authorization procedures.