MedicaidPrior AuthMedium impact
21-387 Acute Hospital Care at Home Program
Health Net·CA · Critical Care, Internal Medicine, Family Medicine·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net Medi-Cal has established a new Acute Hospital Care at Home program allowing eligible hospitals to provide inpatient-level acute care services in patients' homes. Prior authorization is required for these services, and hospitals must obtain CMS waivers and reference home care in admission notifications.
Action Required
Immediately: Billing teams at participating hospitals must ensure prior authorization is obtained from Health Net or delegated PPGs before providing acute care inpatient services at home. Update admission notification processes to reference that the member is accessing the benefit using home care. Contact Dr. Shawn Hamilton to discuss program participation and member reporting requirements.