MedicaidPrior AuthMedium impact
21-130 Offer 24-Hour Non-Emergency Medical Transportation to Medi-Cal Members Who Need a Ride to Pharmacies and Urgent Care (Dual Risk)
Health Net·CA·Prior Authorization
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Summary
Participating physician groups and hospitals with dual-risk financial responsibility for non-emergency medical transportation (NEMT) in Fresno, Kings, and Madera counties must now authorize and coordinate 24-hour NEMT services to pharmacies and urgent care facilities for Medi-Cal members. This change supports the transition of Medi-Cal pharmacy services to fee-for-service under the new Medi-Cal Rx program managed by Magellan.
Action Required
Immediately: Dual-risk PPGs and hospitals in Fresno, Kings, and Madera counties must establish authorization and coordination protocols with transportation providers to ensure 24-hour NEMT access for Medi-Cal members needing rides to pharmacies and urgent care facilities. Update provider operations procedures and contact CalViva Health at 888-893-1569 for questions.