MedicaidPrior AuthMedium impact
21-389 Acute Hospital Care at Home Program
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
CalViva Health has established an Acute Hospital Care at Home program for Medi-Cal members in Fresno, Kings and Madera counties. Hospitals must obtain CMS waivers to participate and prior authorization is required for all acute care inpatient services delivered at home.
Action Required
Hospitals interested in participating must: 1) Apply for CMS waiver through the online waiver application portal for each individual CMS Certification Number, 2) Contact Dr. Shawn Hamilton to discuss program implementation and member reporting procedures, 3) Submit admission notifications that specifically reference the member is accessing home care benefits, 4) Obtain prior authorization from CalViva Health for all medically necessary acute care inpatient services at home.