MedicaidPrior AuthMedium impact
22-917 Long-Term Care Benefit for Medi-Cal
Health Net·CA·Prior Authorization
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
Effective January 1, 2023, Health Net will now authorize and cover medically necessary long-term care services in skilled nursing facilities for Medi-Cal members. Providers must submit completed Long-Term Care Authorization Notification Forms and supporting clinical documentation to Health Net's LTC Intake Line for prior authorization.
Action Required
Immediately: Billing team must update workflows for Medi-Cal long-term care members in SNFs. Providers must submit completed Health Net Long-Term Care Authorization Notification Form plus supporting clinical documentation (PASRR, MDS, or TAR) to Health Net LTC Intake Line via fax at 855-851-4563 before providing services. Include Health Net prior authorization number on all claim forms. Verify member eligibility monthly to ensure claims are directed to Health Net instead of Medi-Cal fee-for-service. Contact LTC Intake Line at 800-453-3033 for questions or status checks.