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CommercialCoverageMedium impact

22-409 Medication Trend Updates and Formulary Changes - 1st Quarter 2022

Health Net·CA·Pharmacy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

HealthNet California has issued formulary changes and medication safety updates for Q1 2022, affecting pharmacy benefits and medication coverage. The policy references a PDF with specific formulary changes that billing teams need to review for potential prior authorization and coverage impacts.

Action Required

Action needed
Immediately: Billing team must access and review the formulary changes PDF at providerlibrary.healthnetcalifornia.com to identify specific medications affected by coverage changes. Update prior authorization requirements in billing system for any newly restricted medications. Notify providers of formulary changes that may affect prescribing patterns and require alternative medications or prior authorizations.