MedicaidPrior AuthMedium impact
21-486 See What News is Online for June 2021
Health Net·CA · Pediatrics·Prior Authorization
Effective date
Jun 30, 2021
We identified it
Jun 20, 2026
Summary
This policy update summarizes three key changes: timely access standards for appointment scheduling, introduction of ConferMED eConsult platform for specialist input, and elimination of prior authorization requirements for pediatric subspecialist office visits effective immediately.
Action Required
Immediately: Billing team must update prior authorization requirements to remove office visit approvals for pediatric subspecialists. Continue requiring prior auth for in-office procedures by pediatric subspecialists as specified in the provider update. Verify coordination of benefits procedures are being followed.