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MedicaidCoverageMedium impact

21-243 Help Delay or Prevent the Onset of Type 2 Diabetes

Health Net·CA · Family Medicine, Internal Medicine, General Practice +1 more·Prior Authorization
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net Medi-Cal has established a new Diabetes Prevention Program (DPP) as a covered benefit for eligible members with prediabetes in specific California counties. Providers can now refer qualifying Medi-Cal members to this evidence-based lifestyle program administered by Yes Health, Inc. using a specific referral form.

Action Required

Action needed
Immediately: Primary care providers should begin identifying eligible Medi-Cal members with prediabetes (A1c 5.7-6.7%, BMI ≥25 or ≥23 for Asian patients) in the specified California counties. Complete the Diabetes Prevention Program Provider Referral Form and fax to 800-628-2704 with proper PHI cover sheet. Update patient education materials to include information about this new covered benefit.