MedicaidPrior AuthHigh impact
23-823 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. This change affects all provider types including physicians, hospitals, and ancillary providers in 9 specified California counties.
Action Required
By October 15, 2023: Billing team must download the Provider Update PDF from Health Net's website to identify which specific drugs and services now require prior authorization. Update billing system workflows to flag these items for prior auth verification before services are rendered. Train front desk staff to verify prior authorization status for affected services. Claims will likely be denied without proper prior authorization.