CommercialPrior AuthHigh impact
22-106 Temporary Changes to Prior Authorization Requirements Due to COVID-19 Surge
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net has temporarily waived prior authorization requirements for hospitals experiencing COVID-19 surge conditions, including transfers to rehabilitation facilities, home health, skilled nursing, and routine DME like wheelchairs and oxygen supplies. The waiver applies during the federal COVID-19 public health emergency and reduces daily concurrent review requirements for ICU patients.
Action Required
Immediately: Billing team must identify which Health Net patients are being transferred from surge hospitals to avoid unnecessary prior authorization requests for acute rehab, home health, long-term acute care, skilled nursing, swing beds, and routine DME (manual wheelchairs, oxygen, CPAP devices, hospital beds, walkers, wound care supplies). Continue to notify Health Net of all hospital admissions via fax or 800-995-7890. Note: Electric wheelchairs still require prior authorization.