MedicaidPrior AuthMedium impact
22-1064 Keep Up with Prior Authorization Changes to Drugs and Nutrition
Health Net·CA·Prior Authorization
Effective date
Dec 9, 2022
We identified it
Jun 20, 2026
Summary
HealthNet California has updated prior authorization requirements for certain drugs and nutrition codes. Providers in Fresno, Kings, and Madera counties must obtain prior authorization for specific codes that now require it, though the specific codes are not listed in this policy text.
Action Required
Immediately: Download the full Provider Update PDF from HealthNet's provider library to identify which specific drug and nutrition codes now require prior authorization. Update billing system and encounter forms to flag these codes for prior auth. Train staff on new requirements to prevent claim denials.