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MedicaidAdministrativeMedium impact

21-416 New Reporting Requirements for Third-Party Liability

Health Net·CA·Prior Authorization
Effective date
Aug 8, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net has implemented new standardized reporting requirements for Third-Party Liability (TPL) cases involving Medi-Cal members. Providers must now assist Health Net by providing TPL claims information using a DHCS-approved Excel worksheet within 30 days when requested.

Action Required

Action needed
When requested by Health Net: Billing team must complete the DHCS-approved Excel worksheet with all required TPL data elements including member information, claim details, diagnosis codes, CPT codes, and payment amounts. Submit requested documents within the timeframe specified in Health Net's request letter (must allow Health Net to meet 30-day DHCS deadline). Ensure staff can quickly access and compile TPL-related claims data for Medi-Cal members.