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MedicaidPrior AuthMedium impact

21-293 New Medications Added to the Prior Authorization Requirements List

Health Net·CA · Oncology, Hematology, Neurology +4 more·Prior Authorization
Effective date
Jan 1, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net has added 12 new medications to their prior authorization requirements list, effective immediately. These include newly FDA-approved injectable medications and specialty drugs that now require PA approval before administration or dispensing.

Action Required

Action needed
Immediately: Clinical staff must obtain prior authorization from Health Net before prescribing or administering Blenrep, Monjuvi, Scenesse, Spravato, Tecartus, Uplizna, Viltepso, Zepzelca, Oxlumo, Breyanzi, Evkeeza, and Nulibry. Update EMR alerts and provider workflows to flag these medications. Access PA forms at Health Net provider website under 'Services Requiring Prior Authorization'. Contact Provider Services at 800-675-6110 for questions.