MedicaidPrior AuthMedium impact
23-218 Follow Organ Transplant Referral and Authorization Process to Avoid Delays
Health Net·CA · Family Medicine, Internal Medicine, General Practice +9 more·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net has updated their organ transplant referral and authorization process, requiring all transplant requests to go through the Centene Centralized Transplant Unit (CTU) with specific fax numbers for different plan types. The policy outlines different processes for Medi-Cal members under/over 21, Medicare plans, and commercial plans, with transplant centers now required to submit requests directly rather than through PCPs or specialists.
Action Required
Immediately: Update referral workflows to ensure organ transplant authorization requests are submitted by transplant centers directly to the Centene CTU. Use fax 833-769-1141 for Medi-Cal members 21+, fax 833-769-1143 for individual Medicare plans, and fax 833-769-1142 for employer group Medicare plans. Train staff that PCP/specialist requests for major organ and bone marrow transplants will be returned and must be resubmitted by the transplant center. For Medi-Cal members under 21, refer to California Children's Services (CCS) program first.