← Back to list
26-1171 Changes to Behavioral Health Peer-to-Peer Reviews
Act
by Dec 15, 2026
Effective date
Dec 15, 2026
Identified
Oct 10, 2026
Summary
Effective December 15, 2026, HealthNet California will discontinue pre-determination peer-to-peer (P2P) reviews for behavioral health prior authorization requests for Medi-Cal members in Imperial County. Post-determination P2P reviews for denied authorizations will remain available. Medical necessity criteria and authorization timeframes are unchanged.
Get alerts when payers change rules like this one
We check Health Net and other payers every day and email you when a change matches your specialty and state.
Get Health Net alertsPolicy Monitoring is free. No card required.
What to do
by Dec 15, 2026 · 4 steps
01Behavioral health providers and billing staff should update internal prior authorization workflows to eliminate pre-determination peer-to-peer review requests for Medi-Cal members in Imperial County.
02Train staff that P2P reviews will only be available post-determination for denied authorization requests, accessed via instructions in denial letters.
03Verify current authorization submission processes in billing and clinical systems reflect this change.
04No changes needed for medical necessity criteria or authorization timeframes.
Original notice
26-1171 Changes to Behavioral Health Peer-to-Peer Reviews
providerlibrary.healthnetcalifornia.com · Always check the source before changing claims.