MedicaidPrior AuthMedium impact
22-525m Request Authorization for Recuperative Care (Medical Respite Care)
Health Net·CA · Family Medicine, Internal Medicine, General Practice +1 more·Prior Authorization
Effective date
Jul 25, 2022
We identified it
Jun 20, 2026
Summary
HealthNet California now requires prior authorization for recuperative care (medical respite care) services in 9 specific counties. This policy establishes a new authorization process for post-acute care services provided outside traditional healthcare settings.
Action Required
Immediately: Billing team must obtain prior authorization from HealthNet California before providing recuperative care/medical respite services to Medi-Cal members in Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties. Download and review the eligibility tips and authorization process PDF from the provider library. Claims submitted without prior authorization will be denied.