CommercialPrior AuthMedium impact
20-140 Medication Trend Updates and Formulary Changes - 1st Quarter 2020
Health Net·CA · Oncology, Urology, Sleep Medicine +3 more·Prior Authorization
Effective date
Jan 1, 2020
We identified it
Jun 20, 2026
Summary
Health Net updated their formulary and prior authorization requirements for Q1 2020, affecting multiple medications across commercial, Medi-Cal, and Medicare Part D plans. Several new medications require prior authorization or have been moved to non-formulary status, while some brand-name drugs are losing patent protection and generic alternatives will become available.
Action Required
Immediately: Billing and clinical staff must review the updated formulary changes for Health Net commercial, Medi-Cal, and Medicare Part D plans. Verify prior authorization requirements for newly listed medications including Nubeqa, Piqray, Sunosi, Turalio, and Xpovio before prescribing. Update pharmacy reference materials and notify providers of alternative medications for non-formulary drugs. Contact Health Net pharmacy services at provided phone numbers for specific authorization requirements.