MedicaidCoverageMedium impact
26-782m Medication Trend Updates and Drug List/Formulary Changes - 3rd Quarter 2026
Health Net·CA·Pharmacy
We identified it
Jul 2, 2026
Summary
Health Net California has released a quarterly medication trend update and formulary/drug list changes for Q3 2026. The policy requires providers to review drug list updates, formulary changes, drug benefit modifications, and medication safety issues. A provider update PDF contains the specific details and applies to physicians, practitioners, PPGs, and behavioral health providers in 10 California counties under Medi-Cal.
Action Required
Immediately: All billing and clinical staff must download and review the Provider Update PDF from the Health Net California provider library at the URL provided. Identify which medications in your practice formulary may be affected by Q3 2026 changes. Update billing software, encounter templates, and pharmacy verification processes to reflect any coverage changes, prior authorization requirements, or formulary tier adjustments. Notify prescribing providers of any medication safety issues or coverage restrictions. For Medi-Cal claims in Amador, Calaveras, Inyo, Los Angeles, Mono, Sacramento, San Joaquin, Stanislaus, Tulare, and Tuolumne counties: verify patient eligibility and medication coverage before processing claims to avoid denials due to formulary changes.