MedicaidPrior AuthMedium impact
22-526m Request Authorization for Recuperative Care (Medical Respite Care)
Health Net·CA · Family Medicine, Internal Medicine, Emergency Medicine +1 more·Prior Authorization
Effective date
Jul 25, 2022
We identified it
Jun 20, 2026
Summary
HealthNet California now requires prior authorization for Medical Respite Care (recuperative care) services for Medi-Cal members in Fresno, Kings, and Madera counties. This policy provides eligibility criteria and authorization process guidance for providers offering recuperative care to homeless or housing-insecure patients who need temporary medical housing after discharge.
Action Required
Immediately: Billing team and providers in Fresno, Kings, and Madera counties must obtain prior authorization from HealthNet before providing Medical Respite Care services to Medi-Cal patients. Download and review the eligibility tips and authorization process PDF from the HealthNet provider library. Update workflows to include prior auth step for recuperative care referrals.