MedicaidAdministrativeMedium impact
20-615 Sleep Apnea as a Risk Factor for Your Patients
Health Net·CA · Family Medicine, Internal Medicine, General Practice +4 more·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net California has issued guidance for providers to actively screen and evaluate patients for obstructive sleep apnea (OSA) during routine health exams, particularly for patients with risk factors like obesity, diabetes, hypertension, and heart conditions. This policy emphasizes the importance of using screening tools and refers patients for sleep studies when indicated, but does not establish new prior authorization requirements despite being categorized under that heading.
Action Required
Immediately: Providers should incorporate OSA screening questions into routine health exams for patients with risk factors (arrhythmia, hypertension, coronary artery disease, diabetes, obesity). Consider implementing screening tools like STOP-Bang questionnaire or Berlin Questionnaire in clinical workflows. Document screening results and refer patients with positive findings for comprehensive sleep evaluation.