MedicaidPrior AuthMedium impact
20-441 New Prior Authorization Requirements
Health Net·CA · Oncology, Hematology, Ophthalmology +1 more·Prior Authorization
Effective date
Aug 11, 2020
We identified it
Jun 20, 2026
Summary
Health Net Medi-Cal now requires prior authorization for specific injectable medications in Los Angeles County hospitals and clinics. Some medications require PA immediately, while others require PA starting August 11, 2020.
Action Required
Immediately: Billing team must obtain prior authorization before administering Adakveo® and Givlaari® injectable medications. By August 11, 2020: Obtain prior authorization for 13 additional medications including Blincyto®, Ozurdex®, Erbitux®, and others listed in the policy. Update EMR templates to flag these medications for PA requirements. Contact Health Net Medi-Cal Provider Services at 1-800-675-6110 for questions.