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MedicaidAdministrativeMedium impact

21-271 Report Third-Party Liability

Health Net·CA·Prior Authorization
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net is implementing new reporting requirements for third-party liability (TPL) tort cases affecting Medi-Cal members in 9 California counties. Providers must prepare to submit TPL data using a new DHCS-approved Excel template format with specific data elements including member information, claim details, diagnosis codes, CPT codes, and payment amounts.

Action Required

Action needed
Before final APL release: Billing team should begin using the new DHCS-approved Excel template format for all third-party liability submissions. Update systems to capture all required data elements including member information, claim details, diagnosis codes, CPT codes, and payment amounts. Contact Health Net Provider Services at 800-675-6110 within 60 days with questions. Monitor for Health Net's separate update with final requirements.