MedicaidPrior AuthMedium impact
22-768m Give Priority to Members With COVID-19 Symptoms or Who Test Positive
Health Net·CA · Family Medicine, Internal Medicine, General Practice +2 more·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net California now requires priority scheduling for COVID-19 positive members to assess eligibility for monoclonal antibody infusion treatments and other COVID-19 therapeutics. Monoclonal antibody infusions are covered benefits with normal cost shares and prior authorization applying after June 1, 2021, but treatments must be initiated within 5-7 days of symptom onset.
Action Required
Immediately: Front desk staff must prioritize appointment scheduling for members with COVID-19 symptoms or positive tests. Providers should offer urgent appointments for evaluation of COVID-19 therapeutics eligibility within 5-7 days of symptom onset. Billing team should verify that monoclonal antibody infusion treatments follow normal prior authorization guidelines and cost shares. Contact CalViva Health at 888-893-1569 for questions about coverage or billing.