MedicaidPrior AuthMedium impact
22-745 New Medications Added to Prior Authorization Requirements
Health Net·CA · Oncology, Cardiology, Ophthalmology +2 more·Prior Authorization
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Summary
Health Net has added several new medications to their prior authorization requirements for Medi-Cal LA-DHS members, with different effective dates from January 2022 through July 2022. Providers must obtain prior authorization before prescribing these specific medications or claims will likely be denied.
Action Required
Immediately: Billing and clinical staff must update prior authorization workflows to require PA for RylazeTM, SaphneloTM (effective Jan 1, 2022), FyarroTM, Ryplazim®, SusvimoTM, TivdakTM, Xipere® (effective April 1, 2022), and EnjaymoTM, Kimmtrak®, Leqvio®, Tezspire®, Vabysmo®, Vyvgart® (effective July 1, 2022). Access Health Net's provider portal under Working with Health Net > Additional Resources > Services Requiring Prior Authorization for current PA requirements. Contact Health Net Provider Services within 60 days with questions.