MedicaidPrior AuthMedium impact
22-621 See What News Is Online for July 2022
Health Net·CA·Prior Authorization
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
Health Net published a comprehensive update summarizing multiple policy changes from July 2022, including a key requirement for prior authorization for recuperative care (medical respite care) for Medi-Cal members effective immediately. The update also includes changes to Medi-Cal enrollment processes, housing navigation services, and various provider resources.
Action Required
Immediately: Billing team must implement prior authorization requirements for recuperative care (medical respite care) services for all Medi-Cal members. Update billing system to flag these services for prior auth before submission. Review the recommended authorization process outlined in communication 22-525m. For January 1, 2023: Prepare for Medi-Cal beneficiary transitions from fee-for-service to managed care plans - update patient eligibility verification processes.