MedicaidPrior AuthMedium impact
23-786 Acute Hospital Care at Home Program Extends Through 2024
Health Net·CA · Critical Care·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 hospitals with CMS waivers to provide acute inpatient services to Medi-Cal members at home. Prior authorization is required for all acute care inpatient services delivered through this home-based program.
Action Required
Immediately: Billing team must ensure prior authorization is obtained from Health Net before providing acute care inpatient services at home for Medi-Cal members. When submitting admission notifications, reference that the member is accessing the benefit using home care. Only hospitals with approved CMS waivers can participate and bill for these services at standard inpatient rates.