Medicare AdvantagePrior AuthMedium impact
22-533 What News Is Online for June 2022
Health Net·CA · Oncology, Endocrinology·Prior Authorization
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Summary
Health Net California published a summary of four June 2022 policy updates including: new member notification templates for authorization withdrawals, expanded Medi-Cal coverage for blood pressure monitors and glucose devices, elimination of prior authorization for cancer biomarker testing effective July 1, 2022, and a new invoice form for Enhanced Care Management services.
Action Required
By July 1, 2022: Billing team should stop requiring prior authorization for biomarker testing for patients with advanced or metastatic cancer. Update billing system rules to remove prior auth requirements for these tests. Use new member notification templates when requesting authorization withdrawals or dismissals. Consider using the new Enhanced Care Management invoice form for ECM-related services to reduce errors.