MedicaidPrior AuthMedium impact
22-108m Clinical Trials that Require Prior Authorization
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net Medi-Cal now requires prior authorization for certain routine care costs associated with qualifying clinical trials, but these requests will be processed within 72 hours if marked as 'Routine Care Cost Services Associated with the Clinical Trial' for urgent status. An interim process is in place until the California State Attestation Form is published.
Action Required
Immediately: For any routine care costs requiring prior authorization that are part of qualifying clinical trials, billing team must indicate 'Routine Care Cost Services Associated with the Clinical Trial' on all prior authorization requests to receive urgent 72-hour processing. Submit requests via fax to 800-743-1655. Once the California State Attestation Form is published, include this form with all clinical trial routine care prior authorization requests.