MedicaidPrior AuthMedium impact
23-788 Acute Hospital Care at Home Program Extends Through 2024
Health Net·CA·Prior Authorization
Effective date
Dec 31, 2024
We identified it
Jun 20, 2026
Summary
The Acute Hospital Care at Home program has been extended through December 31, 2024, allowing eligible Medi-Cal members to receive acute inpatient services at home. Prior authorization is required from Health Net/CalViva Health for these services, and hospitals must have an approved CMS waiver to participate.
Action Required
By December 31, 2024: Billing team must ensure prior authorization is obtained from Health Net/CalViva Health before providing acute hospital care at home services to Medi-Cal members. When submitting admission notifications, reference that the member is accessing the benefit using home care. Verify that the hospital has an approved CMS waiver before billing these services at standard inpatient rates.