MedicaidPrior AuthMedium impact
21-214 Post-Stabilization Authorization for Emergency Out-of-Network (OON) Hospital Services Suspended
Health Net·CA · Emergency Medicine, Critical Care·Prior Authorization
Effective date
Mar 18, 2020
We identified it
Jun 20, 2026
Summary
Health Net has suspended all out-of-network hospital post-stabilization authorization reviews since March 2020 due to COVID-19. Participating Physician Groups (PPGs) must refer these authorization requests back to Health Net instead of reviewing them internally.
Action Required
Immediately: Billing team must refer all out-of-network hospital post-stabilization authorization requests to Health Net at 1-888-893-1569. Do not process these authorizations internally. Update workflow procedures to automatically route these requests to Health Net for adjudication.