MedicaidPrior AuthMedium impact
22-110m Clinical Trials that Require Prior Authorization
Health Net·CA · Oncology, Cardiology, Neurology·Prior Authorization
We identified it
Jun 20, 2026
Summary
CalViva Health now requires prior authorization for certain routine care costs associated with qualifying clinical trials in Fresno, Kings, and Madera counties. These requests receive urgent processing within 72 hours when properly submitted with the required attestation form.
Action Required
Immediately: For any routine care costs requiring prior authorization in clinical trials, indicate 'Routine Care Cost Services Associated with the Clinical Trial' on all submissions to receive urgent status. Submit requests via fax to 800-743-1655. Once published, include the California State Attestation Form with all clinical trial prior authorization requests. Billing team should monitor for the attestation form publication and update workflow accordingly.