MedicaidPrior AuthMedium impact
22-360 Summary Update: Medical Policies - 1st Quarter 2022
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
CalViva Health has updated their medical policies for 1st Quarter 2022, affecting prior authorization requirements for procedures and services in Fresno, Kings and Madera counties. These policies apply when California Department of Health Care Services policies are not available and may require providers to obtain prior authorization before delivering services.
Action Required
Immediately: Review the complete policy document 22-360 on CalViva Health's medical policies page to identify specific procedures requiring prior authorization. Update workflow to check CalViva Health prior authorization requirements for members in Fresno, Kings and Madera counties when state Medi-Cal policies are unavailable. Contact CalViva Health at 888-893-1569 for clarification on specific authorization requirements.