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MedicaidPrior AuthMedium impact

23-426sum Medical Policies - 1st Quarter 2023

Health Net·CA·Prior Authorization
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

CalViva Health released their first quarter 2023 medical policies update affecting prior authorization requirements for procedures and services. These policies apply to CalViva Health members in Fresno, Kings, and Madera counties when no state Department of Health Care Services policies are available.

Action Required

Action needed
Immediately: Review the complete policy update 23-426 available at Medical Policies section to identify specific prior authorization changes. Billing team must ensure prior authorization is obtained before services are provided as required by the new policies. Contact CalViva Health at 888-893-1569 with questions about specific authorization requirements.