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MedicaidPrior AuthMedium impact

22-897 Know What's New and Changing: 2023 Prior Authorization List

Health Net·CA·Prior Authorization
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Days to comply

Summary

HealthNet California has updated their prior authorization list effective January 1, 2023, requiring prior authorization for additional drugs and services. This affects hospitals and clinics, with specific application to Medi-Cal members in Los Angeles county.

Action Required

Action needed
By January 1, 2023: Clinical and billing teams must review the updated prior authorization list and update workflows to obtain prior authorization for newly listed drugs before prescribing or administering. Update EMR systems and encounter forms to flag services requiring prior auth. Failure to obtain prior authorization may result in claim denials.