Medicare AdvantagePrior AuthHigh impact
26-832 State of Emergency: Palos Warehouse Fire in Los Angeles County
Health Net·CA·Prior Authorization
Effective date
Jun 20, 2026
We identified it
Jun 25, 2026
Summary
Health Net is suspending standard prior authorization, precertification, and referral requirements for Los Angeles County members affected by the Palos Warehouse Fire (declared state of emergency June 20, 2026). Providers can request shortened approval timelines and extended authorization validity periods. Out-of-network services will be approved when in-network providers are unavailable, prescription refill limits are suspended, and claims filing deadlines are extended.
Action Required
IMMEDIATE (effective June 20, 2026): Billing team must implement emergency workflows for Health Net Los Angeles County claims: (1) PRIOR AUTHORIZATION: Stop enforcing standard prior auth denials for affected members; contact Health Net Provider Services using line-of-business phone numbers to request expedited auth approvals and extended validity periods. (2) OUT-OF-NETWORK CLAIMS: Process out-of-network provider claims without standard authorization if member's in-network provider is unavailable due to fire impact. (3) CLAIMS FILING: Extend internal claims submission deadlines for impacted providers—contact Provider Services for specific extended timeframes and update billing system submission rules accordingly. (4) PRESCRIPTIONS: Process emergency prescription fills at out-of-network pharmacies without prior authorization or refill limits for affected members; apply current copayments/deductibles. (5) MEDICAL EQUIPMENT: Approve replacement medical equipment/supply authorizations without standard prior auth—providers must call Provider Services to confirm. Contact the appropriate Provider Services line based on plan type (Ambetter IFP/PPO: 844-463-8188; Ambetter HMO: 888-926-2164; Health Net HMO/POS/PPO: 800-641-7761; Medicare/Wellcare: 800-929-9224; Medi-Cal: 800-675-6110). Failure to implement these changes may result in inappropriate claim denials for emergency/disaster-related services.