MedicaidCoverageMedium impact
26-783m Medication Trend Updates and Drug List/Formulary Changes - 3rd Quarter 2026
Health Net·CA · Pharmacy·Pharmacy
Effective date
Jul 1, 2026
We identified it
Jul 2, 2026
Summary
HealthNet California has released Q3 2026 medication formulary and drug list updates effective 07/01/26. This policy requires providers to review medication benefit changes and medication safety issues documented in the Provider Update PDF. The changes apply to Medi-Cal beneficiaries in Fresno, Kings, and Madera counties.
Action Required
By 07/01/2026: Billing and clinical teams must download and review the Provider Update PDF from https://providerlibrary.healthnetcalifornia.com/news/26-783m-medication-trend-updates-and-drug-list-formulary-changes.html to identify specific medication formulary changes, covered/non-covered drugs, and any new prior authorization requirements. Update internal formulary reference materials and alert prescribing providers to changes. Communicate any new medication restrictions or coverage limitations to front-desk staff handling prior authorizations. Failure to implement formulary changes may result in claim denials for non-covered medications or unpaid claims due to missing required prior authorizations.